You know that familiar parody of infomercials: “It’s a dessert topping! It’s a floor wax!” Sometimes it seems that Botox has achieved that same level of hype, and that every time you turn around someone is promoting another use for the popular cosmetic injectable.
Maybe it’s compelling to envision Botox as a solution to a wide range of problems because of its incredible success in its most popular application: smoothing wrinkles. After all, more than 2.5 million Botox treatments were administered last year, said the American Society for Aesthetic Plastic Surgery, and the number continues to grow annually despite the poor economy. The successful marketing strategies of Allergan, the manufacturer, also play a part. According to an article in Fortune Magazine earlier this month, Allergan predicts a whopping $1.4 million in Botox sales in 2010.
Obviously, Botox isn’t the answer for everything. It’s not even the answer for some of the conditions it is said to treat. Let’s take a look.
Dynamic wrinkles – yes. In the spring of 2002, Allergan was granted U.S. Food and Drug Administration approval for the use of Botox to treat glabellar (forehead) wrinkles. These and other lines caused by repeated muscle action are the most popular targets for Botox injections.
Other wrinkles – not so much. Wrinkles caused by the loss of facial volume, such as nasolabial folds (those parentheses around your mouth) are better treated with fillers such as Restylane and Juvederm.
Eye conditions – yes. Certain eye problems related to muscle action, like crossed eyes, were actually among the first conditions Botox was known to treat. The FDA gave thumbs up for this use in the mid 1980s.
Neck spasms – yes. The FDA granted approval for Botox to relieve cervical dystonia, or involuntary contraction of the neck muscles, soon after the approval for treating eye conditions.
Sweating – yes. In 2004, the FDA approved Botox for use in treating excessive underarm sweating, medically-termed “hyperhidrosis.” (Some doctors use the injectable for other overly sweaty body parts, like the hands.)
Migraine – probably. This is an “off label” use, meaning that many doctors have found Botox to be an effective migraine treatment, but it has not been approved for that purpose by the FDA. In fact, Allergan has been recently fined upwards of $600 million for jumping the gun in marketing Botox for migraines. But it is expected that approval will be forthcoming in the not too distant future.
Breast Lift – no. A few years ago, there was a flurry of interest in Botox for lifting saggy breasts. The theory was that by paralyzing certain torso muscles, the breasts would be lifted by the remaining muscles. There is no evidence that this works.
Spasticity – yes. In March of this year, the FDA approved the use of Botox for muscle spasms of the fingers, wrists and elbows in adults. These issues are common after strokes and brain injuries and accompany the progression of multiple sclerosis.
That’s the list of leading Botox applications, or rumored applications, although there are a few other health conditions Botox is said to ease. The list is long—and it probably has not yet stopped growing.
http://www.surgery.org/sites/default/files/2009stats.pdf
http://money.cnn.com/2010/09/09/news/companies/Allergan_Botox_settlement_FDA.fortune/index.htm
http://www.fda.gov/downloads/Drugs/DevelopmentApprovalProcess/HowDrugsareDevelopedandApproved/ApprovalApplications/TherapeuticBiologicApplications/ucm088278.pdf
http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm203776.htm
http://www.hsus.org/web-files/PDF/ARI/botox_timeline.pdf