Who is Qualified to Inject Botox?

Botox is the common name for the commercially-produced, purified protein that can relax muscles. It is widely used in non-surgical cosmetic procedures to correct wrinkles and rejuvenate skin. However, Botox is also a treatment for multiple medical conditions including spasms, dystonias, chronic migraines, and severe sweating, or hyperhidrosis. While Botox has become an extremely common procedure, one question you should ask yourself when looking for treatment is, who is qualified to inject Botox?

Following clinical trials, in 2002, the FDA approved Botox Cosmetic, the botulinum A toxin, for moderate-to-severe glabellar lines. “The treatment temporarily improves the skin’s appearance by relaxing definition lines and lines of motion in the skin,” says Dr. Miriam Hanson, Cosmetic Dermatologist in Austin, Texas.

Injected into the muscles, Botox inhibits their contraction, which in turn can prevent wrinkles. “The most noticeable improvement is with ‘dynamic wrinkles,’ caused by muscle contraction,” explains Dr. Hanson. As we age, those wrinkles become permanent. “Botox helps smooth these creases, but can also work as a preventative treatment, preventing these fine lines from developing in the first place.”

“Some states restrict performance of Botox injection to licensed physicians,” says Dr. Adam Mamelak, dermatologist and skin surgeon at Sanova Dermatology. The Texas Medical Board Rule 193.17, for non-surgical cosmetic medical procedures, allows fully trained and licensed physicians to delegate the procedure to midlevel practitioners, including nurse practitioners, physicians assistants, and others.

Physicians must complete appropriate instruction, including hands-on training, before performing or delegating Botox injections. A record of the physician’s training is kept and available for review by patients upon request. A physician, or the designated midlevel practitioner, before the procedure, must take a patient history, perform an appropriate exam, make a diagnosis, and follow many practices associated with other medical treatments.

When deciding to have a Botox treatment, ensure the individual is an experienced injector. Ask to examine their training history. If the injector is not a doctor, know who the delegating physician is. Ask for testimonials about the results, for both the person and the facility. Remember, there can never be too many questions.

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