What conditions does botulinum toxin treat?

In cosmetic medicine, botulinum toxin is used to address signs of ageing by relaxing facial muscles and smoothing fine lines and wrinkles. Treated areas include the forehead, around the eyes, nose, lips and chin.

In neurology, botulinum toxin is used to manage various conditions associated with excessive or abnormal tissue activity. The most commonly treated neurological conditions include:

• Cervical dystonia – involuntary neck muscle contractions causing the head to twist or turn into uncomfortable positions.

• Blepharospasm – uncontrollable eyelid movements, such as blinking or twitching.

• Hemifacial spasm – involuntary twitching of muscles on one side of the face.

• Limb spasticity – muscle stiffness and involuntary spasms in the arms or legs.

• Chronic migraine – headaches occurring on at least 15 days per month.

• Strabismus – misalignment of the eyes (crossed eyes).

• Overactive bladder – unstable bladder contractions causing urinary urgency and frequency.

Botulinum toxin also stops sweat production and is used to treat excessive sweating, such as under the arms (axillary hyperhidrosis), on the hands (palmar hyperhidrosis), and on the soles of the feet (plantar hyperhidrosis).

Similarly, it can reduce saliva production and is used in conditions whereby excess saliva is produced, or where the saliva can no longer be swallowed normally, such as in Parkinson’s disease or motor neuron disease.

Other conditions it may help treat include:

• Bruxism – teeth grinding or clenching.

• Tremors.

• Trigeminal neuralgia – recurring episodes of severe facial pain.

You should discuss with your doctor whether botulinum toxin injections are the right treatment for your condition.

Depending on the procedure, you may be eligible for a Medicare rebate or a PBS subsidy.

Botulinum toxin (commonly referred to as Botox) is a highly targeted neurotoxin used to manage excessive muscle activity, abnormal nerve signalling, and unwanted glandular secretion across a wide range of clinical conditions. Although often associated with cosmetic procedures, its therapeutic use is well-established in neurology, pain medicine, urology, ophthalmology and rehabilitation medicine.

Medically, it is used to treat cervical dystonia (painful, involuntary neck muscle contractions), blepharospasm and hemifacial spasm (involuntary twitching of the eyelids or face), and limb spasticity in conditions such as stroke, cerebral palsy, or multiple sclerosis. It is also an approved treatment for chronic migraine, where it is injected in a standardised protocol across specific head and neck muscles to reduce the frequency of headache days in eligible patients.

Other clinical uses include the management of bruxism (teeth clenching or grinding) by relaxing the jaw muscles, and hyperhidrosis (excessive sweating), where it can effectively reduce perspiration in the underarms, hands, and feet. Botulinum toxin is also used for sialorrhoea (excess saliva production), especially in neurodegenerative conditions like Parkinson’s disease and motor neuron disease.

For patients with facial pain or trigeminal neuralgia who have not responded to medication, botulinum toxin may provide adjunctive relief. In ophthalmology, it is used to correct strabismus (misaligned eyes) in selected cases, and in urology, it helps manage overactive bladder by calming involuntary bladder contractions.

This treatment is not suitable for all patients and should only be administered following a thorough medical assessment. Accurate diagnosis, precision in injection technique, and individualised care planning are essential to achieve optimal outcomes. In some cases, botulinum toxin treatment may be supported under Medicare or PBS funding when prescribed by an appropriate specialist.

If you are considering botulinum toxin therapy for a medical condition, speak to a qualified healthcare provider experienced in its clinical application.