BOTOX® Yields Promising Results

Touted as the “lunchtime facial”, the ultimate defense against aging, a miracle treatment for various muscle spasm disorders, and now potential relief for migraine headaches, back pain, stuttering, and excessive sweating, BOTOX® has amassed an unprecedented resume of uses, if clinical trials result in FDA approval. Considering that BOTOX® is derived from a deadly poison initially designed for biological warfare and is extracted from the toxin of one of the most prominent causes of food poisoning, this is an astounding achievement.

BOTOX® knows few age and no gender boundaries when it comes to diminishing or removing wrinkles and brow furrows. A forty-year-old female engages in lively conversation as she reclines in the examination chair. Pulling a few loose strands of hair away from her face, the skin is swabbed with alcohol. She has declined the offer of a topical anesthetic. After closing her eyes and lifting her brow, the BOTOX® Cosmetic is injected through a fine-gauge needle straight across the forehead, between the eyebrows, and around the outer corners of the eyes. Within minutes, she is examining the tiny red bumps in the mirror, as the only indication the treatment is complete. Within an hour, the signs of treatment will disappear. More importantly, within 24 hours to ten days, the wrinkles will have faded as well. The effect will generally last from four to six months.

The motives inspiring people to undergo BOTOX® treatments are as different as the individuals themselves. While some regard BOTOX® as a revolutionary anti-aging cure and a welcome alternative to an intrusive facelift, others equate the injections to their yearly eye exam and schedule two or three treatments a year as an essential aspect of their routine healthcare.

The old adage that youth is wasted on the young is being dispelled by the popularity of BOTOX® treatments among patients in their twenties. As we age, the skin’s elasticity decreases and loses its supple texture. Realizing that at an older age lines can be softened but not completely eradicated, twenty-somethings are opting to stop wrinkles before they can start. Beginning BOTOX® treatments early stops the muscles from contracting, leaving the skin nearly impervious to the damage caused by years of living life to the fullest. While BOTOX® treatments have been deemed harmless, certain behaviors like smoking and sunbathing, that initially create wrinkles and lines, are dangerous in and of themselves.

How does a compound with a renowned reputation for being one of the deadliest toxins on earth gained unprecedented acceptance as a versatile medical drug? With its origins as a biological warfare agent and responsible for food poisoning in canned foods, scientists dismissed it due to its volatile nature. However, they were intrigued by its ability to attach itself to neurotransmitters, blocking them from communicating with the muscles and preventing contractions. In the late 1970s, botulinum was being used to treat a variety of muscle problems including crossed eyes and uncontrollable blinking. Soon the FDA gave approval for treating these two conditions with BOTOX®.

In 1991, Allergan purchased the exclusive rights to BOTOX®. Allergan invested years and millions of dollars into research and development before submitting BOTOX® to the FDA for approval, and it has paid off. The implications of BOTOX® usage are expanding into many medical areas with potentially promising benefits. Unlike many drugs that produce specialized effects on one or few disorders, BOTOX® is being used in clinical trials addressing more than ninety distinct conditions (most notable are Parkinson's disease, stroke, and cerebral palsy) that previously had no course of treatment.

FDA approval opened the door to exploring the possibilities with BOTOX®, as doctors are allowed to use FDA-approved drugs for purposes other than the one prescribed. With the green light to use BOTOX® off-label, doctors across the country were submitting protocols to hospital boards for approval, treating patients, and recording reactions. Some patients reported symptom relief as minimal, others experienced phenomenal results, while others reported a significant enough change to warrant continued usage. As a pain management tool for migraine headaches and back pain, BOTOX® has been reported to have a more powerful effect than traditional painkillers that can adversely affect the liver. As with any drug therapy, results vary according to the patient’s physiology and type of condition being treated. The perfect drug is as elusive as the unicorn, but BOTOX® holds the potential to be a quick, noninvasive medical procedure with little recovery time.

In the early '90s, ophthalmologist Jean Carruthers, M.D. observed that her patients being treated for ocular disorders with BOTOX® experienced a dramatic decrease in wrinkles. After experimenting on herself and her husband, a dermatologist, she was convinced BOTOX® was effective in reducing the appearance of lines and wrinkles. Three years and 30 willing, satisfied participants later, BOTOX® became a serious therapeutic option... In April 2002, BOTOX® gained FDA approval as a cosmetic treatment.

BOTOX®'s rapid -- almost instantaneous -- acceptance by patients and the medical community alike is understandable considering previously available options. BOTOX® is generally quick and effective if administered professionally. Unlike other more involved cosmetic procedures like facelifts, BOTOX® is affordable and convenient and is appealing to patients who prefer to “test drive” the results before committing to a permanent solution, since effects last no longer than three to six months.

Despite its unique properties, BOTOX® should be given the same serious consideration as any other drug on the market. Its success is only as good as the doctor who performs the treatment and the patient’s response. Patients must choose their BOTOX® provider carefully, as results are dependent on the mixture concentration level and the doctor’s experience. BOTOX® is delivered as a freeze-dried powder and must be mixed with saline prior to injection. Without the correct concentration, patients might experience zero effect or droopy eyelids, numbness, and dry mouth. Beware of advertisements offering BOTOX® treatments at an enormously discounted rate. Remember, if the offer seems too good to be true, it probably is. It is crucial to find a doctor you trust.

As BOTOX® gains increasing popularity and a stronghold in the market, clinical trials are increasing to assess the numerous benefits and uses. Protocols are being cultivated and executed for cosmetic purposes as well as treating more serious diseases. From these trials, ideal dosages and reports of remarkable results are being presented at medical forums and conventions worldwide. BOTOX® continues to yield very promising results.

George A. Wooming, M.D. is a board certified dermatologist. He is a graduate of the University of Miami School of Medicine where he received his Doctor of Medicine degree. He holds memberships in the American Academy of Dermatology, the American Academy of Cosmetic Surgery, the American Society for Dermatologic Surgery, the Texas Medical Association and the Dallas County Medical Society.