“Botox of the feet”: a phenomenon that is happening in France?

What is foot botox?

You should know that Botox is only the name of a brand. This is botulinum toxin, which exists under different brands in France, marketed by four different laboratories. So, we will talk about botulinum toxin treatment.

In the feet, there are two indications for this treatment. The main one is excessive sweating. It is an effective treatment, but in the case of the feet there is a downside since it can be really painful. I generally prefer to do it in the operating room with the patient asleep by a short sedation.

Botulinum toxin would also relieve pain associated with wearing high heels. Is this really the case?

Yes, the other major indication of botulinum toxin in the feet concerns chronic inflammation associated with wearing very high heels. At the level of the internal part of the plantar arch and at the level of the metatarsophalangeal joints, there are often points of support, just before the toes. They are accentuated in women who wear excessive heels and this leads to pain that can be extremely debilitating. We can inject botulinum toxin to reduce this nervous sensation of pain, but it must also be combined with an anti-inflammatory such as a long-term corticosteroid so that the inflammation of the small interosseous ligaments and the tendons of the muscles stops, so so that the patient can resume a more or less normal support. It should also be noted that for some time the patient should stop wearing such high heels, namely more than 9 centimeters.

In the United States, this type of treatment is said to be booming due to the return of post-Covid heels. What about in France?

Fortunately, excesses in terms of shoes are less frequent in France than in certain states of the United States where indeed women, even when working, have huge nails and wear extremely high heels. For a modern French woman, it’s much rarer because jumping on the metro to go to work still involves wearing a decent, relatively comfortable pair of shoes. It is therefore a phenomenon that is less widespread than in the United States. But you should know that this treatment works very well for this type of pain.

We identify the painful places, and we inject botulinum toxin associated with Diprostene or Kenacort Retard – the corticosteroid calms the inflammation and the botulinum toxin slows down the nerve transmission of pain. Under local anesthesia, it is necessary to make 2 to 3 punctures with very fine needles according to the importance of the painful points. It is necessary to inject deeply to get flush with the bone relief if it is calcaneitis, then to compress to avoid having a hematoma. It is a treatment that costs between 400 and 500 euros because botulinum toxin is a drug with marketing authorization.

We know that botulinum toxin is effective in reducing certain signs of aging and now that it can be beneficial against excessive sweating and plantar pain. Are there other indications?

Botulinum toxin can help reduce excessive expression lines on the forehead, glabella, and outer corner of the eyes or crow’s feet. But you have to keep some wrinkles because they also have charm. It is also used to avoid the inversion of the labial commissures which make the mouth so sad, and also to reduce the hypertonicity of the neck which results in sometimes very unsightly platysmal cords. Finally, in plastic and aesthetic surgery, we also use botulinum toxin for painful cervical points, and to improve the trophicity of excessively inflammatory scars. It is not necessarily known, but the medical indications of botulinum toxin are multiple such as excessive contraction of the perineum or vaginismus, and certain very localized muscle spasms such as in migraine or blepharospasm which will be treated by ophthalmologists… The toxin Botulinum is a very interesting drug with many therapeutic possibilities.

*Interview of Dr Bergeret-Galley with Christelle Pellissier, colleague at ETX Studio.