Botox Used for Medical Conditions,Is Botox the aspirin of the new millennium?
by Krisha McCoy
When it was first introduced as a treatment for lazy eye in 1989, the most remarkable fact about Botox was that its main ingredient is the same toxin that causes the deadly food poison botulism.
The very idea of injecting a poison into your body was radical indeed.
Now 17 years later, people are getting Botox injections to smooth out the wrinkles on their foreheads. Little is made of the dangerous Clostridium botulinium bacterium, its main ingredient. Very few cases of adverse Botox reactions have been reported.
Evidence now suggests that Botox may be able to treat a number of medical conditions, including headaches, excessive sweating, cerebral palsy, overactive bladder, enlarged prostate, tennis elbow — the list goes on.
Botulinium toxin in an injectable form (Botox) can selectively prevent muscles from contracting, and that’s the factor that makes it so appealing.
Botox was first approved by the U.S. Food and Drug Administration (FDA) in 1989 to treat the eye disorders blepharospasm (uncontrollable blinking) and strabismus (lazy eye). It has since been approved to treat cervical dystonia (severe neck contractions) and severe underarm sweating.
But Botox has achieved its fame and popularity as a remedy for wrinkles, such as removing frown lines between the eyebrows. When doctors first started using Botox for wrinkles, it was an off-label usage, meaning it wasn’t yet approved by the FDA for that particular application.Researchers are still figuring out exactly how Botox works, and each discovery leads to a number of new off-label ways it may be used to treat medical conditions.
“If there is a disease that involves an overactive muscle, that disease is potentially treatable by Botox,” says Dr. Eric Finzi, the medical director and president of Chevy Chase Cosmetic Center in Chevy Chase, MD. For instance, Finzi says, Botox can work on the muscles that control sweating, on those that cause wrinkles on the face and on those in the scalp that are related to getting headaches.
The evidence that Botox can treat a wide variety of conditions is mounting.
One study, published in the August 8, 2002, issue of the New England Journal of Medicine, compared the effects of Botox to a placebo in 126 people who had disabling muscle tightness or twitching in the hand as the result of having a stroke. Twelve weeks into the study, the participants who received Botox experienced greater improvements than those who received a placebo.
The results of a more recent study, which will be presented at the 2006 meeting of the American Urological Association, found that Botox injections improved urinary tract symptoms and the quality of life in men with enlarged prostates. The improvements were seen up to one year following the injection in some of the participants.Another recent study, conducted by Finzi and his colleagues and published in the May 2006 issue of Dermatologic Surgery, reported that injecting Botox into frown lines between the eyes not only smoothed out wrinkles, but relieved symptoms of depression. These findings are preliminary however, and the study was very small — including only 10 patients who were suffering from depression. Two months after the Botox treatment, nine of them were no longer clinically depressed.
Why? Finzi suggests that whether wrinkles are present, tense facial muscles may be linked to a depressed mood. But more extensive research is needed to determine whether Botox can really help treat depression.
Is it possible that Botox really is the cure-all these studies hail it to be? “Botox is not a magic molecule, but it can work on any kind of muscle that is overactive,” Finzi says.
Serious side effects from Botox injections are rare. Some patients experience soreness and mild bruising in the area around the injection. Other side effects may include headache, upset stomach, flu-like symptoms or a temporarily droopy eyelid (associated with forehead injections).
The benefits of Botox don’t last forever. “Botox is not a permanent drug,” Finzi says, “By definition it always wears off.” How long it lasts depends on the area of the body it is being used in. When used for treating wrinkles in the face, for example, the effects of Botox last for about three to four months. When used under the arms for sweating, the results may last six to nine months.As researchers continue to uncover new uses for Botox, the FDA may approve it for treating more medical conditions. When getting Botox treatments, Finzi recommends seeing a practitioner who is experienced and has been well trained on how to use Botox. “When administered appropriately,” Finzi says, “I feel that Botox is safer than aspirin.”
Resources
The U.S. FDA’s Botox fact sheet gives a good overview of what to look for when considering Botox treatments.
SOURCES: U.S. Food and Drug Administration, Rockville, MD; Eric Finzi, MD, PhD, medical director and president of Chevy Chase Cosmetic Center, Chevy Chase, MD; August 8, 2002, New England Journal of Medicine May 23, 2006, press release, University of Pittsburgh Medical Center; May 2006, Dermatologic Surgery. American Academy of Dermatology, Washington, DC.
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