3 Things You May Not Know About Botox


We all want to look and feel our best, and for most of us, that goes hand-in-hand with maintaining a youthful look. One solution, of course, is the injectable treatment, Botox. Since the 1980s, Botox has become one of the most common, safest and cost-effective cosmetic procedures used to combat signs of aging. There’s tons of information out there and due to the its widespread popularity, most of us know the basic tenets of Botox by now. But here are three facts you may not know about this cosmetic treatment.

1. Botox has been used for decades as a medical treatment, and its cosmetic properties were actually discovered by accident.

In the 1960s, ophthalmologist Alan Scott, MD, and Edward Schantz, a pioneering biochemist in the realm of toxins, began to study the medicinal, therapeutic possibilities of the Botulinum toxin, the effective neurotoxin known by its trade name, Botox. The toxin itself already existed, but until Scott and Schantz’ work, it was known to cause Botulism poisoning and didn’t boast any positive uses.

However, by 1980, Botox was an accepted medicinal treatment for crossed eyes (strabismus) and eye twitching (blepharospasm). A little over a decade later, a dermatologist was standing in for his ophthalmologist wife when he realized that none of her patients had wrinkles, according to Harvey “Chip” Cole, III, MD, of Atlanta’s Oculus Plastic Surgery. Out of this dermatologist’s observation, the idea that Botox could be used for cosmetic purposes was born. In 1992, the Canadian pair published the first piece of research proving that Botox could help diminish frown lines.

Though primarily known for its cosmetic properties, Botox is still used medicinally to remedy a range of conditions, including abnormalities of the eye muscles.

“It has potential use for any condition where the muscles need to be relaxed,” says Dr. Cole, a quadruple-board-certified cosmetic surgeon who spends time on the national and international lecture circuit, educating and instructing others about Botox.

Some of the more common conditions treated by medical Botox include:

  • Hyperhidrosis, or excessive sweating
  • Migraines
  • Uterine conditions, and as a supplement during uterine operations
  • Conditions of the vocal chords
  • Various abnormalities of the eye
  • Incontinence, or overactive bladder
  • Certain muscle tension and stiffness
  • Pain and discomfort associated with cervical dystonia

2. Botox can be used prophylactically to prevent the onset of wrinkles.

Most people think of Botox as a wrinkle treatment, but Cole says, “More and more we’re seeing people in their twenties receiving Botox to prevent wrinkles, not treat them.” He explains that by relaxing the muscles of the face in areas prone to wrinkle — around the eyes and mouth especially — those muscles’ range of motion is smaller over time, leading to fewer, less severe wrinkles.

But can the use of Botox so early lead to muscular problems in the future? Cole says no. “It’s like a light switch. Botox only has a mechanism of action that’s about three to four months.” Once the effects of the relaxing agent wear off, the muscle will resume normal functioning, full range of movement and capacity.

3. Botox brow lifts are the real deal.

Don’t get too excited yet — Cole says to be cautious when seeking Botox brow lifts. Using Botox as a way to lift the brow requires the effort of a skilled technician, so make sure that you find an experienced injector.

Cole says his Botox brow lifts are based on balance — “like a see-saw.” Cole says, “I relax the muscle that pulls the brow down,” which allows the muscles pulling the brow up to do double duty. “I purposefully put the muscles off balance to lift the brow.”

While it doesn’t completely eliminate the signs of aging, Botox wrinkle treatment has been proven a safe, effective way to minimize them. “I work in a world of millimeters, not inches,” Cole adds.

Sure, you likely know someone who has had a Botox treatment to erase wrinkles. But what do you really know about this multipurpose medical treatment?

Researchers have looked at botulinum toxin, from which Botox is made, for more than 100 years. The protein and neurotoxin produced by the bacterium Clostridium botulinumm was first studied as the cause of botulism, an illness people sometimes get from improperly prepared meats.

But more than half a century ago, scientists began studying how the toxin might affect neuromuscular processes and possibly be used in medicine. Now it is used to treat everything from wrinkles to chronicmigraine.

Botox celebrates 25 years.

 In December 1989, the U.S. Food and Drug Administration (FDA) approved Botox, a form of botulinum toxin type A manufactured by Allergan, for treatment of two rare eye muscle disorders”strabismus (crossed eyes) and blepharospasm (uncontrollable blinking). Almost immediately, researchers began experimenting with use of Botox to improve the appearance of wrinkles, and in 2002, the FDA approved Botox Cosmetic. The rest, as they say, is history.

One use of Botox leads to another.

 Many of the uses of Botox were discovered by physicians using it to treat other conditions. For example, I started using Botox for movement disorders in 1996 during my fellowship at Henry Ford Hospital. When my mentor, Dr. Lori Schneider, died unexpectedly, I took over the clinic and started treating patients for cervical dystonia, spasticity, blepharospasm, hemifacial spasm and spasmodic dysphonia. In 1997, I was introduced to the possibility of using Botox for migraine. Dr. William Binder found that his patients who were receiving Botox for wrinkles had an improvement in their migraines. At the time, I wasn’t convinced the therapy could work for migraine. But, in 2004, I became a lead investigator on a chronic migraine clinical study, which ultimately led to approval of Botox for treating chronic migraine, a condition defined as having 15 or more headache days each month, with headaches lasting four hours a day or longer, and at least half of those headache days being associated with migraine. Since then, I have seen how Botox has benefitted many patients living with chronic migraine.

Botox is approved for eight medical conditions. 

In addition to the two cosmetic uses for Botox, here are the medical conditions for which Botox is currently FDA-approved:

  • Blepharospasm (uncontrolled blinking of the eyelid)
  • Cervical dystonia (a painful condition in which neck muscles contract involuntarily)
  • Chronic Migraine
  • Overactive bladder
  • Overactive bladder caused by a neurologic condition (NDO)
  • Severe underarm sweating
  • Strabismus (a misalignment of the eyes, commonly known as crossed eyes)
  • Upper limb spasticity (can cause stiffness in the elbow, wrist and finger muscles)

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