Botox Featured in Time Magazine

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Botox was on the cover of the January 16, 2017 edition of Time Magazine in an article titled “How Botox became the drug that’s treating everything.” Depicted as a Swiss army knife, the article discusses the many uses of Botox for many conditions. Over the past decade or so, Botox has become a household name, primarily from its cosmetic use to treat facial wrinkles. But Botox is also being used for a variety of other conditions in a number of medical subspecialties.

What is Botox?

Botox is a purified protein used to address wrinkles associated with facial expression. When injected into the skin Botox will relax muscles and smoothen out the wrinkles. Botox is approved for treatment of the vertical frown lines or 11’s seen between the eyebrows when we frown and the crow’s feet seen around the eyes when we smile. Botox is also used off-label for many different areas on the face and neck.

Botox Discovery

Botox was originally studied in the 1970’s to treat strabismus, a condition that causes eyes to be crossed. Originally called Oculinum, Botox was approved by the FDA for this purpose in 1989. Just two years later in 1991, Allergan (the company that now makes Botox) purchased Oculinum for nine million dollars. At that time the name was changed to Botox. This was back when Allergan was focused primarily on eye care and treating eye disorders. In 1998 Allergan began studies on using Botox for cosmetic purposes and the drug was approved by the FDA in 2002 to treat frown lines. Since the initial discovery of Botox the market has exploded. Between 1989 and 1991 Allergan sold $13 million in Botox. As recently as 2013 Allergan has a reported $2 billion in revenue from Botox. There have been over 12 billion Botox treatments worldwide in the last 25 years.

Safety of Botox

The safety of Botox has been demonstrated in many studies. Many have a misconception that Botox can cause severe illness. This is because the source of the protein is a bacteria that causes botulism. Botulism is an infection caused when people eat foods contaminated with the bacteria. When the bacteria gets into the body it travels throughout the bloodstream, multiplies, and releases high levels of a toxin called botunilum toxin. The toxin blocks nerves from transmitting the signals for muscles to contract. If it affects certain muscles it can cause difficulty swallowing or breathing. So why is Botox so safe for cosmetic purposes? This is a very common question. First the product used in Botox is a purified protein, not the entire bacteria. The whole bacteria is required for replication in the body to amounts that cause significant illness. Since the whole bacteria is not in the medication, the amount of the protein will not increase after it is injected into the skin. Second the doses of Botox used for cosmetic treatments are miniscule, as they treat the small muscles in the face. The dose of Botox is not enough do significantly effect muscles required for vital purposes such as eating and breathing. Third, Botox is injected into the skin and there is a minimal amount that gets into the bloodstream.

Other Uses of Botox

Botox is now being used for over 200 different conditions. Some of these conditions were identified by luck. For example, Botox is used to treat chronic migraine headaches. This was discovered when a doctor noticed that people with migraine headaches being treated with Botox for wrinkles developed fewer migraines. This is similar to the discovery of cosmetic use of Latisse, a prescription-strength product which enhances the length and thickness of eyelashes. Latisse was originally used to treat glaucoma as a drug called Lumigan or bimatoprost, also by Allergan. It was noticed that patients using Lumigan developed longer eyelashes. Quickly the product was rebranded as Latisse and is now used to enhance lashes. Botox is used for other cosmetic purposes on the face and neck which are considered off-label, meaning that studies have not been done on the areas. Outside of cosmetics Botox is also used for muscle spasms, excessive sweating, TMJ pain, bladder disorders, and even depression.

Article by
Encino Physician