Off-Label Uses For Botox: What Can the Injection Really Do?

Jager Weatherby on 26 Sep 2014 at 8:00pm

BotoxWe all know Botox is primarily used as a wrinkle relaxer, but it started out as something entirely different. In fact, Botox has far more uses than originally intended and they don’t all have to do with anti-aging.

“Botox was originally used for crossed eyes and eye-twitching,” says Los Angeles plastic surgeon Dr. Gary Motykie. “But then physicians noticed that wrinkles around the eyes were being reduced as well. To date, the FDA has approved Botox for the treatment of four problems: eye muscle disorders, neck muscle disorders, excessive sweating, and eyebrow furrows.”

Of course, it takes awhile to gain FDA approval to ensure quality, safety, and effectiveness. Until that happens, physicians are free to use previously approved drugs for unapproved reasons — known as “off-label” uses — much like they did with Botox before it was approved for wrinkle relaxation.

MORE: “Off-Label” Drug Use By a Physician: Is It Safe?

“These off-label uses are often found accidentally,” Dr. Motykie reveals. “The treatment of chronic migraines with Botox injections was first inadvertently observed during its routine use for the treatment of wrinkles in the forehead. In other cases, physicians have begun to use Botox in other places of the body knowing that it relaxes muscles. When off-label uses result in good outcomes, they are published in journals or presented at conferences, which facilitates the spread of knowledge to other physicians. This can lead the manufacturing company to run multiple studies and gather data to prove the safety and effectiveness to these new uses. They can then request the FDA for review and ask for formal approval to include the procedure as a new indication.”

Curious what other conditions Botox might treat? Dr. Motykie enlightens us on the many other uses of this versatile neurotoxin:
Anal fissures
Chewing problems
Hair loss
Inner ear disorders
Overactive bladder
Pain from fibromyalgia
Pain from missing limbs
Painful intercourse
Pelvic muscle spasms
Sinus headaches and migraines
Swallowing problems 
Uterine problems

As with any cosmetic procedure, Dr. Motykie warns that off-label uses need to be approached carefully. “Things can go wrong,” he explains. “Muscles in the neck or lip can be temporarily paralyzed. Be careful that your doctor doesn’t attempt ‘trial and error’ with a nerve poison. Like any drug, if you take too much, you will have side effects.”

MORE: Why Choose a Board-Certified Plastic Surgeon?

Check the FDA and Allergan websites to stay updated on approved uses for Botox. Most importantly, “make sure your injector is either a board-certified physician or working under the very watchful eye of one.”

Dr. Gary Motykie

About Dr. Gary Motykie

Dr. Gary Motykie is a plastic surgeon based in West Hollywood, California. He’s been featured as a regular surgeon on Dr. 90210, Plastic Surgery: Before & After, and The Doctors.