It is the cosmetic procedure that has been on everyone’s lips in recent weeks - and there is more to Botox than there might appear on the face of it.
From British pharmacies offering cut price treatments on the high street to unlicensed beauticians flying into Dubai offering unregulated home visits, it is a treatment rarely out of the headlines.
Dubai surgeons said Botox, or botulinum toxin, is the most popular non-invasive treatment of choice to smooth out wrinkles and restore a youthful look.
But doctors are increasingly using the toxin to treat patients with wide ranging health complaints from migraines to muscle disorders and bladder complaints.
Injections of the drug into the bladder wall have successfully treated patients with overactive bladders, with 80 per cent of patients at an Al Ain hospital experiencing impressive results when other medications have failed.
“In most cases, patients have had no effect from other medications, yet they experience a direct effect from the Botox treatment, which is often much stronger,” said Dr Enrico Dassen, a consultant urologist at Medeor 24x7 International Hospital.
“A thin tube called a cystoscope is inserted into the bladder and a tiny camera is attached to the tube so we can look at the inside of the bladder.
“Through the tube, several injections of Botox are made into the specific sites of the bladder wall.
“The effect is immediately seen as the injections are given inside the bladder in the muscle.
“It’s a quick procedure with minimal discomfort, and the effect can last from six to 12 months,” said Dr Dassen.
Patients with an overactive bladder may be passing urine more frequently, have a strong uncontrollable urge to pass urine or lack of bladder control during the night.
Botox works by temporarily paralysing the muscle within the bladder, calming the nerves that usually overstimulate it, leading to an urgent feeling of needing to urinate.
Common abnormalities of the nervous system that can cause the condition are Parkinson's disease, multiple sclerosis, stroke, dementia, diabetes, spinal cord abnormalities, pelvic trauma or a drop in oestrogen levels in women due to menopause.
Patients are offered the Botox treatments if other more traditional remedies or medications have failed, and are in and out of hospital on the same day.
Botox injections cost, on average, Dh1,500 and are also used to treat chronic neurological conditions, neck pain, muscle cramps, twitching eyelids or even excessive sweating at clinics in Dubai.
British retailer Superdrug has been offering injections for just £99 (Dh 460) at a London branch under its Skin Renew Service.
Botox is used by doctors at the Dubai German Neuroscience Centre on patients when conventional medications have failed, or if they have suffered adverse side effects.
Neurologist Dr Manio Maravic said most patients are unaware of the wider medical applications of Botox.
“Many are assuming Botox is used only for cosmetic treatments, but it is particularly useful for pain management in patients with advanced migraines,” he said.
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Earlier this month, immigration authorities deported a Swedish woman without a visa who was alleged to have been providing unlicensed Botox fillers to patients in Dubai during visits from the UK.
In 2017, the Ministry of Health and Prevention warned of a rise in back-street beauticians offering unlicensed cosmetic procedures for a fraction of the price of regulated clinics.
Botox is a common service on offer, the department said.
The ministry said some beauty centers outside the licensed health institutions may temporarily employ visiting doctors who bring in low-quality cosmetics and conceal patient medical reports.
The Medical Liability Act requires doctors to give a thorough description of any treatment, dose and method of use in a clearly written statement with the name and signature of the practitioner, and the date of prescription.
“When instances of malpractice are uncovered, security authorities conduct seizures, with violators transferred to the appropriate judicial authority,” said Dr Amin Al Amiri, assistant undersecretary for public health policy and licensing at the ministry.