There are many types of botulinum toxin type A. At Durham Private Doctors we use only Botox for facial and medical aesthetics.  If toxin is required for Wow Fusion treatments, Bocouture is sometimes used as it does not require cold chain storage and is easily mixed with the mesotherapy.

Botox is made from a purified protein by the pharmaceutical industry for medical and cosmetic purposes. When Botox is injected into muscle, it blocks the nerve pathway and therefore stops the activation of muscle contraction. In other words, Botox relaxes the muscle and blocks or reduces movement. By doing this, wrinkles and creases caused by repeated muscle contraction can be targeted, reduced, removed or even prevented. Botox also has an incredible beneficial effect on the skin quality by its action on the sebum glands in the skin.

Botox has been on the market for over 20 years and has a well-established safety history. It has been researched and tested extensively to ensure that it is effective and safe to use.

Botox is relatively inexpensive when compared to other cosmetic procedures and surgery. It is safe in trained hands, minimally invasive, requires no down time and achieves results very quickly. For those considering more permanent solutions, it is often a good first step.

Historically, cosmetic treatments have been more commonly used in women, but recent years have shown an increase in treatments for men, interested in reducing e.g. frown lines, crows feet and also excessive sweating.

Cosmetic/Aesthetic Uses

Cosmetically, Botox can be used in many ways to reduce the outward signs of the natural ageing process.  Botox can be used to lift (brow or down-turned corners of the mouth),  to drop (a gummy smile) as well as relaxing muscles to soften existing creases as well as preventing lines from forming. A dimpling (bum) chin can be relaxed and Botox can also be used to narrow or feminise a square and muscular jaw.  In addition, Botox improves the skin quality, texture and appearance by working on the sebum glands to reduce sebum and oil production. Botox can be mixed with mesotherapy for the Wow fusion microneedling treatment. This works within the skin, rather than deep to the muscles, to improve and brighten the skin.

Medical Uses

Botox has many medical uses.  It is especially effective at treating excessive sweating known as hyperhidrosis. Commonly it is injected into the armpits. The Wow fusion device now allows treatment of the scalp, face, hands very easily.  The effects are almost immediate and last many months up to 1 year.

Teeth grinding (bruxism) can be treated using Botox.

Botox is now licenced and recognised by NICE for the treatment of Chronic Migraine. This treatment is extremely challenging to obtain on NHS due to current lack of resources, long waiting times and limited clinic space.  This is often a life changing treatment for the correct patients. Please discuss this with Dr Marsden.


Botox treatment is tailored to suit the individual patient and a review is carried out after 2 weeks. At this stage further treatment can be administered if clinically appropriate. This follow up appointment is included in the initial pricing and there is no charge should further injections be required at this review.

Botox injections are relatively quick, minimally painful and are often described as a pinching or nipping sensation. The toxin starts to work on the muscle by day 4 but the effects are often not seen until day 7, and the full effect occurs by day 10.

The muscle relaxing action of Botox is usually for 8 weeks. This then very gradually wears off with the benefits usually lasting for 12 weeks.  Botox treatment often lasts longer than 12 weeks, especially in patients who have regular treatments. Some patients attend twice yearly with great results in between.

Some people worry about the loss of facial expression with Botox whilst other people want a total glass-like and motionless look. The results can be tailored to suit the individual and not all approaches are suitable for all clients or for all ages. Dr Marsden will discuss the safest and best approach for you. It is important that we know your medical history and your current medications. There are very few exclusion criteria for Botox treatment, with the main ones being pregnancy, breastfeeding and some rare neuromuscular conditions. Those who are prescribed anti-coagulants (blood thinners) can still have treatments with extra care to minimise bruising.

All patients must be over 18 years of age and ID may be required if there is any doubt.

After treatment:

  • Do not rub the treated area.
  • Avoid strenuous activity same day.
  • Avoid alcohol same day.
  • Avoid facial treatments such as peels, dermabrasion etc. for 24 hours.
  • Remain upright for 4 hours after treatment.
  • Do not apply heat to the affected area same day.
  • Use facial expression to exercise the treated muscles same day.
  • Bruising, tenderness and headache can occur and are usually brief

If you have any concerns then contact your doctor.

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