Mar 2, 2017

Botox Working Magic on Areas Beyond the Face

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Botox is widely recognized for its work in smoothing out wrinkles, but the history and the future of the miracle serum expands far past the world of cosmetic procedures. The muscle-relaxing injection has been used to treat everything from various forms of muscle stiffness and twitching, to incontinence and chronic migraines. A recent study argues that Botox could even possibly aid in fighting the effects of depression.
 
QUITE HELPFUL FOR A TOXIN
The Dublin-based pharmaceutical company Allergan is the principal North American supplier of botulinum toxin A, commercially known as Botox. In recent years, Allergan has pushed for new US Food and Drug Administration approvals so that Botox can continue expanding its uses for the product.

Originally FDA approved in 1989 to treat eye muscle problems, the first approval for cosmetic use didn’t happen until 2002. Since then, Botox has been vigorously researched and currently holds FDA approval for seven different uses, including severe urinary incontinence, excessive underarm sweating, upper and lower limb spasticity, and chronic migraines.

"We give 31 little injections around the forehead, sides of the head, back of the head, neck and shoulders," said Dr. Randolph Evans, who treats some of his chronic migraine patients with Botox since its approval in 2010. "About 50% of people who get it have their headaches reduced by half or more.”

A 2012 FDA approval allowed for Botox to be used to help elderly and those with neurological conditions who suffer from issues with their bladder.

"It can really be life changing for someone with severe incontinence issues," said Dr. Charles Nager, the co-director of the University of California, San Diego Women's Pelvic Medicine Center.
 
STILL #1 WRINKLE-FIGHTING WARRIOR
The drug’s iconic use overwhelmingly remains in the area of cosmetics – and within that area, Botox still touts the top spot. Of the 14.2 million minimally-invasive cosmetic procedures performed in 2015, Botox overwhelmingly beat out soft tissue fillers and chemical peels with 6.7 million procedures.

Another Botox-related win for Allergan came in 2013 when the FDA expanded the drug’s cosmetic use from just the glabellar region, the area in between the eyebrows, to include improving the appearance of “lateral canthal lines,” known commonly as crow’s feet.
 
A BRIEF HISTORY OF THE MIRACLE SERUM
Before its use in cosmetics, botulinum toxin, found its way into medical use through the research of the muscle affecting disease, botulism. Like most toxins isolated for medical use, Botox holds value in its ability to block signals from nerves to muscles.

It was mainly used by doctors to treat patients with various types of muscle spasms, starting with optical muscle disorders and eventually moving into face, neck and limb. Doctors like Dr. Gerard Francisco of TIRR Memorial Hermann in Houston had been using Botox to treat spasticity or muscle stiffness since 1994.

"Spasticity is quite often seen in people after a stroke, brain injury, spine injury, multiple sclerosis, practically anything that affects the brain or spinal cord," said Dr. Francisco.

In the 1980’s, Canadian couple Dr. Alastair Carruthers and Dr. Jean Carruthers stumbled upon the age-fighting use for botulinum toxin when a patient being treated with it for eye spasms mentioned she liked that it got rid of her wrinkles. The couple presented their strange discovery to the American Society for Dermatologic Surgery meeting in Orlando in 1991, and although initially met with skepticism, their work along with others catapulted the use of the toxin in the cosmetic world: commercial Botox was born.

“There’s no putting the genie back in the bottle,” said Dr. Carruthers to Reader’s Digest. Since first presented for cosmetic use, Botox has expanded its reach in cosmetic and countless other areas of the medical world.
 
TURN THAT FROWN UPSIDE DOWN
Especially after being approved for cosmetic use, new uses for Botox are constantly being researched and developed.  A June 2016 article in the Journal of Psychiatric Research explored the connection between the muscles involved in facial expressions and emotions. Researchers believe this work may lead to Botox being used to help curb the effects of depression through inhibiting certain negative muscle responses.

“When you inject the frown lines...with Botox or another neuromodulator ...it also blocks the brain’s trigeminal nerve, which is what gives us the ability to frown and also tells the brain that we are sad,” said Dr. Z. Paul Lorenc, New York City plastic surgeon to Reader’s Digest.

For its FDA approved uses, Botox is relatively safe. But because of it’s versatility, many off-label uses for Botox are less researched and should be approached with the expertise of a doctor.

With plenty of momentum, the miracle serum will surely continue to work its relaxing magic on faces and other muscles everywhere, helping people look younger and feel better.

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