Botox: Beyond The Lines


Botox® Cosmetic (botulinum toxin type A) is FDA-approved for the treatment of frown lines between the brows. It is also commonly used to treat forehead furrows and “crow’s feet” lines around the eyes. Because of its excellent safety profile, ease of procedure and quick rejuvenating results, Botox® has become the most common cosmetic office procedure. Although the procedure has become an accepted part of our culture, I’m often asked: “Is there anything I can I tell my friends about getting Botox that doesn’t make me seem vain?”

My answer is "Yes!" Beyond its role in facial rejuvenation, when Botox ® is injected into frown lines between the brows and forehead creases, it simultaneously relieves migraine headaches. Several clinical trials demonstrate the efficacy of Botox ® for people with chronic tension-type headaches, including migraines. Botox ® produces this effect by relaxing the forehead muscles which contract during tension headaches, and also prevents release of pain-stimulating peptides from local nerves. Most people find that getting Botox®in the glabella and forehead precludes the need for other headache therapies. As of November 2010, Botox is FDA-approved for the treatment of migraines.

Botox ®is also effective for depression. A clinical trial (Finzi E et al. Treatment of depression with Botulinum toxin A: A case series. Dermatologic Surgery 2006 May;32(5):645-9) showed that 9 out of 10 patients who met DSM-IV criteria for major depression in spite of pharmacologic or psychotherapeutic treatment were no longer depressed two months after receiving botulinum toxin A to their glabellar frown lines. In my practice, I often see patients who come in once each fall or winter for Botox® because they find it better than any drug for preventing seasonal affective disorder. For some, it’s truly like an annual vaccine or flu-shot for depression.

Botox ® is also the treatment of choice for excessive sweating. Whether the problem is facial, underarm or palmar sweating, the social embarrassment can be significant. Some individuals with excessive underarm sweat production wear special pads and garments to try to ‘stem the tide,’ while many with excessive palmar sweating avoid shaking hands at all costs. When Botox ® is injected into the skin of the underarms or palms, it is able to block excessive sweat production by preventing the release of a chemical, acetylcholine, from nerve endings. This is the same chemical that Botox ® inhibits when it is used for facial rejuvenation. For those who wear suits and are used to having wet shirts by the end of each day, or those who sweat excessively during exercise, Botox® offers a quick, safe solution. Better yet, the control Botox provides for sweat reduction lasts about 9 months.

Finally, I was struck to learn that Botox® used for wrinkle reduction can actually enhance performance at work. Many clients who work in high-stress positions have told me that since getting Botox ® their evaluations at work have improved significantly. In response to my surprise, they explained that their bosses note that they handle stressful projects and situations with poise. The poised appearance results from relaxed muscles in between the brows which prevent instinctive frowning and transforms their usual body language.

In summary, Botox ® is much more than a cosmetic product. It is a tremendous therapeutic intervention for headaches, depression and excessive sweating. Strategic placement of Botox ® provides a bonus of rejuvenation, and may also help you climb the corporate ladder.

Article by
Bellevue Dermatologic Surgeon