Botox Cosmetic is one of the most popular and recognized wrinkle-reducing injectables. It's a class of neurotoxins, botulinum toxin type A, that has been used clinically for decades under different names. In fact, it was during medical use that the cosmetic effects of botulinum toxin were identified! Botulinum toxin is a purified substance that comes from bacteria. In large amounts, it was known to cause botulism. Botox uses such finite amounts of the purified protein that there is virtually no risk of severe complications.