Botox Turning Into “Go-To” Treatment for Unusual Purposes

SignatureMD concierge care doctors are keeping up with the FDA approved (and some not approved, but showing promising results) Allergan drug known as Botox, the staple for cosmetic usage for line smoothing.

There are many uses for botox other than cosmetic, and we discovered some of the latest uses for this “miracle” drug that should only be administered by a board certified cosmetic surgeon.

Botox is the brand name for the eradication of wrinkles, and serves as a shorthand for the entire enterprise of injectable cosmetic medicine.

But now, with the popularization of new medical uses, therapeutic applications of the drug are poised to provide patients with treatments fully covered by insurance that address pain, excessive sweating and more.

Botox is a purified form of botulinum toxin, a nerve poison produced by the bacteria that cause botulism, a disease that paralyzes muscles and can be fatal.

Injections of Botox act like tiny poison darts that temporarily freeze chemical nerve signals to certain muscles or glands.

The F.D.A. has approved Botox to treat four problems: eye muscle disorders, neck muscle disorders, excessive sweating — and that deadly age giveaway, eyebrow lines and furrows. Allergan has applied for patents on more than 90 uses for the drug.

According to recent medical journals, physicians have used it to treat swallowing and chewing problems, pelvic muscle spasms, drooling, neck skin laxity, hair loss, anal fissures and even phantom pain from missing limbs. Botox has been used for sinus headache, fibromyalgia pain, ulcers, inner ear disorders and uterine problems and more trials and studies are turning up in medical journals weekly.

As we age, not only does our face begin to show wrinkles, but the skin on the neck begins to sag. One way cosmetic dermatologists and plastic surgeons are improving the look of this skin is by injecting Botox into the loose bands of neck muscle. It won’t entirely change the appearance, but it can improve the look.

Dr. Peter B. Fodor, a plastic surgeon in Los Angeles, has a novel procedure for a non surgical neck lift called “the Nefertiti Neck lift” by using a series of Botox injections in the neck area, it tightens and sculpts the jaw line with little downtime, and at minimal cost.

Some health advocates worry that doctors are widely adopting novel uses for Botox before federal guidance and rigorous clinical studies have established safe and effective dosages for the new treatments.

Dr. Fodor urges all who seek any Botox treatment to only have a board certified experienced plastic surgeon administer any treatments. “It is possible to over-inject. Things can go wrong. It is rare, but it happens. It is imperative that the doctor you select has the expertise and knowledge of human anatomy to correctly place the injection for the desired result.”

Allergan claims Botox has a long safety track record with 30 years of favorable research, studies on 11,000 people worldwide and 17 million treatments in the United States since 1994.

Botox was developed in the 1970s by Dr. Alan Scott, an ophthalmologist in San Francisco who wished to cure crossed eyes. His rational was that minute doses of a nerve poison could weaken the muscles that pull crossed eyes inward would soften this. He experimented with a variety of paralytic agents.

Then a biochemist who had isolated and purified a strain of botulinum toxin for potential military use as a biological weapon sent Dr. Scott a sample. This one worked.

Dr. Scott named the new drug Oculinum. In 1989, the F.D.A. approved it to treat crossed eyes and twitching eyelids. Allergan bought Oculinum in 1991 for about $9 million, rebranding it Botox. In 1998, Botox had $90 million in annual sales. Last year, sales exceeded $1 billion.

Over the last nine years, the F.D.A. has approved Botox to treat neck muscle spasms and to hinder excessive sweating. The agency also approved the same drug, under the name Botox Cosmetic, to smooth forehead wrinkles.

Allergan expects therapeutic sales of the drug to soon eclipse sales of Botox Cosmetic. The company is expecting federal approval to market the drug for stroke victims suffering from limb tightness or spasms. Allergan plans to seek approval to market the drug for chronic migraine headaches and eventually plans to seek F.D.A. approval to market Botox for benign enlarged prostate.

The approved FDA use for Hyperhidrosis works miracles for those who sweat profusely. It is a condition characterized by excessive sweating, even when the temperature is cool. Overactive sweat glands and uncontrollable sweating can be treated with Botox injections, especially in the underarms and hands. Botox temporarily blocks the nerves that stimulate sweating, and lasts for about six months.

Foot pain is a common problem from wearing certain high heels, and some doctors are relieving the pain with Botox injections in the feet. By injecting Botox into the ball of the foot, it protects the nerves and soft tissue.

Botox use for Temporomandibular Joint Disorder, better known as TMJ, helps alleviate pain for many. Botox is not FDA-approved to treat TMJ, but it has been used off-label for myofascial pain. One study published in the journal Pain concluded that Botox was not ideal for treating TMJ due to its high cost and lack of efficacy.

Botox to treat “Gummy smile,” a cosmetic concern, is not FDA approved, but shows remarkable results with Botox so far. A “gummy” smile, a smile that shows too much of the gums, usually results from “excessive lip elevation” when the upper lip rises too far above the upper teeth when smiling. Injecting Botox into the upper lip weakens the upper lip’s retractor muscles so that it won’t raise as high and your smile will seem better-balanced, according to Dr. Fosor. (source: There are loads of other things that you can do though when it comes to treating your gummy smile, and not all of them need to use botox. For example, you could take a look at something like this gummy smile correction here.

Dr. Fodor says, “This technique is only for surgeons who possess the expert anatomical knowledge for placement of the injection. Too much, and your lip wont raise enough, too little and you will need more, or if injected asymmetrically, you might have an asymmetrical smile.”