People are paying lots of money for botulism, what does it do? Botox is a neurotoxin and it acts on neuromuscular junctions. Nerves usually send signals to your muscles, but Botox interferes in this communication and the muscle becomes essentially paralyzed. Botox actually permanently kills this neuro-muscular junction, but fortunately it regrows over time. That is why Botox wears of every six months.