What You Need to Know about Botulinum Toxin

July 17, 2020 0 Comments

Objective

Botulinum toxins are often prescribed in aftercare and neurological rehabilitation services. In our hospital, they are exponentially used in the treatment of spasticity. The objective of this study is to make an assessment of their use over the period 2012–2015.

Material/patients and methods

All the botulinum toxin prescriptions are followed by the chemists. A traceability form allows to collect information about the patient, the prescriber, the medicine and its dose, the cost, and the indication. All these data are saved in an Excel file. The data from 2012 to 215 concerning the spasticity have been extracted and analysed.

What are you allowed to do? What qualifications are required? Should I become a prescriber? How to find a prescriber to work with?

Derma Medical have been providing advice on this for years. We have pulled together some of the most commonly asked questions regarding prescribing and answered them for you. If you can’t see what you’re looking for or would like to talk it through it in further detail, please contact us.

Doctorsdentistsnurse prescribers and prescribing pharmacists that have trained in administering botulinum toxin are able to write prescriptions to order Botox.

What If I Am Not a Prescriber?

We train many non-prescribers on the course and it is very common for nurses, midwives, pharmacists and other medical professionals without prescribing rights to train in Botox and dermal fillers. In fact, 30-40% of our delegates are non-prescribers.

To obtain botulinum toxin, non-prescribing practitioners will need to buddy up with a local prescriber or use a prescribing service.

Your prescriber will need to complete an initial face to face consultation with the patient before writing the prescription. They do no need to be present when you administer the treatment.

Do I Need a Prescription for Dermal Fillers?

No, once you have completed a training course in dermal fillers you will be able to order products yourself without a prescription. Pharmacies will often ask for copies of you training certificates details of your indemnity insurance when setting up an account.

We will also put you in touch with reps from some of the manufacturers who can offer you discounts and deals for ordering direct.

Buddying up with a Local Prescriber

Buddying up with a local prescriber can be easier than you realise:

  • Contacting medical colleague/ friends who are local and may be able to prescriber for you or recommend someone else that can.
  • Advertising the need for a prescriber on your social media accounts.
  • We also find many prescribers and non-prescribers buddy on our training courses to help each other out.

You can expect to pay the prescriber a small fee of around 10% for consulting the patient and writing the prescription – however the mark up on botulinum toxin treatments is usually 300-400% so you will see make a good profit from performing treatments.

If you don’t have a local prescriber to buddy up with you can also use a prescriber service.

Prescriber Service

Prescriber services have a network of approved local prescribers willing to consult patients and write prescriptions. Typically, these services charge a fee of around £40 for which they send out a local prescriber to review your patient face to face and write a prescription.

Derma Medical are able to recommend prescriber services for delegates to use after completing one of our Botox and dermal filler training courses.

Ordering Botox

Once you have a prescription for botulinum toxin, you will need to order the product.

If you use a prescriber service, they will often order the Botox for you and have it sent out to you. You then pay them for the cost of the products and the consultation fee.

You can also order Botox yourself via one of the online cosmetic pharmacies (HealthXchange, Church Pharmacy and Wigmore Medical are all popular choices). Once you have an account you can add in your prescriber’s details – and then order and pay for botulinum toxin or other prescription drugs. Your prescriber will then be emailed to asked to log in and e-sign the prescription. Once approved, products are then sent out to you by next day delivery allowing you to treat you patient.

Becoming a Prescriber/ V300 Prescribing Course

Nurses, midwives and pharmacists are all able to gain prescribing rights by completing the V300 course. There are also plans to open this qualification up to paramedics and other medical professionals in the near future.

The V300 qualification I usually run through universities so check with your local university or search Google for “v300 course universities”.

We recommend directly contact with the university, who will then be able to five you the best advice and guidance on the latest course information. As well as eligibility, pricing, duration and content may vary.

Universities often like applicants to have 6-12 months experience in non-surgical cosmetic injectable treatments before enrolling on the V300. We would therefore advice you to train on our Foundation or Combined Botox & Dermal Fillers training course first and then apply for the V300 once you have some experience.

Training in Aesthetic Medicine

Derma Medical teach botulinum toxin and dermal filler training courses to medical professionals internationally. We hold regular training courses in London, Manchester, Brisbane, Melbourne, Sydney, Perth (Australia), Stockholm (Sweden) and Dubai (UAE). Our hands-on practical training with more live models, unique landmark based training and business/employment advice make us the UK’s No.1 aesthetic training provider.

How does it work?

Each muscle in our body has associated nerves that tell it when to contract.  In order to do this a neuron (nerve cell) releases a signal in the form of a neurotransmitter called acetylcholine.  Botulinum toxin cleaves one of the proteins on the membrane of neurons that helps them to secrete that acetylcholine.  This renders neurons unable to signal their respective muscles.  It’s essentially like trying slide into someone’s DMs without any cell service or WiFi – your message can’t get out, and you won’t get a response.

What is it used for?

An ever-broadening list of indications from facial rejuvenation to migraines to excessive sweating.  In its cosmetic use it’s mainly targeted at hyperdynamic wrinkles: lines that appear due to repetitive contraction of certain facial muscles we use when making facial expressions.  Examples of these include horizontal forehead lines, the “mean 11” of the glabellar area (between the brows), “crow’s feet” and even wrinkles around the lips.  Additional cosmetic uses allow for subtle shaping of the face – rounding out the jawline, opening the eye and even de-emphasizing band-like protrusions of the neck.

What are the results like?

There’s a reason why botulinum toxin is the most commonly administered cosmetic treatment: it’s very good at decreasing the appearance of expression lines.  Results usually last about 3 months and range anywhere from subtle to “frozen” depending on patient preference.  Some have claimed that having botulinum toxin administered regularly can also have a preventative effect over time, but this claim hasn’t been validated with rigorous studies yet.

What is the process like?

The area to be treated is cleaned.  Numbing creams or ice can be applied beforehand to prevent pain but most patients do fine without them.  A syringe and needle are used to inject the toxin into the dermis, subcutis (just under the skin) or directly into muscle depending on the area being treated.  The process usually takes minutes.  Pain and down time are both minimal.  I usually advise patients not to drink alcohol, exercise or take NSAIDs for the rest of the day to avoid bruising.

What can go wrong?

The most common side effects are pain during the process, bruising and headache.  Our facial musculature is also very complex, meaning that certain areas may be unintentionally paralyzed (i.e. brow droop).  Conversely, incomplete treatment of an area may result in an undesired appearance such a “Spock brows” with high lateral arches.   Many of these are either preventable or correctable.  I highly recommend having a thorough discussion about all the possible side effects with your provider beforehand and to keep in touch with them afterwards in case your results are suboptimal.

Should I get it?

Botulinum toxins should be used as part of a larger rejuvenation plan that includes skincare and procedures targeted at your specific concerns.  My recommendation is to find a reputable provider such as a board-certified dermatologist to review all the options and come up with a synergistic strategy to safely enhance your look.

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