From treating migraines, to stopping excessive sweating - Botox has many off-label uses.

April 2002. George W. Bush is president. Maryland beats Indiana for the NCAA basketball championship. And the Food and Drug Administration approves a drug that proves to be a massive hit, to say the least – Botox.

Botox is approved for the cosmetic use of treating wrinkles and frown lines, the only official approved use by the FDA. Beyond it’s wrinkle treatment, Botox, as it turns out, is extremely effective in a myriad of issues, many of which are not cosmetic. Board certified plastic surgeons of the Plastic Surgery Channel give insights in the secret world of Botox’s superpowers.

BEFORE BEAUTY, BOTOX’S BEGINNINGS HAD MUCH MORE SINISTER INTENTIONS
What few realize is Botox is actually a toxin, related to the deadly botulism. With the outbreak of World War II, the U.S. began researching biological weapons, including botulinum toxin (the nerve toxin used as a basis for Botox), considered to be one of the deadliest substances in the world. One plan was to have Chinese prostitutes slip tiny toxic pills into the food and/or drink of high-ranking Japanese officers. According to the authors, a batch of gelatin capsules filled with botulinum toxin was produced, but the project was abandoned before the poison pills could be put into action. So the substance would then sit on research shelves, awaiting a new application far on the other end of the spectrum from war.

THE SUMMER OF ’69 AND INTO THE 70’S: PEACE, LOVE AND HINTS OF BOTOX’S VERSATILITY
Researchers began focusing on the more beneficial aspects of this powerful toxin, particularly after they discovered injecting small amounts into a hyperactive muscle caused temporary “relaxation.” In the 1960’s, ophthalmologist Dr. Alan B. Scott started injecting botulinum toxin type A into monkeys, theorizing its muscle-relaxing effects might help in the treatment of crossed eyes (or strabismus). More research showed the drug’s benefits went beyond ophthalmology, providing patients with temporary relief from facial spasms, neck and shoulder spasms, even vocal cord spasms. In 1988, drug maker Allergan acquired the rights and changed the drug’s name to the compact, catchy “Botox.”

STIFLING MIGRAINES WITH BOTOX
Early on in its clinical research, Botox was tested for the treatment of migraine headaches.

Tackling migraines with Botox.

“A migraine will take a huge chunk out of someone’s day or week or even life,” says Kevin Smith, MD, a board certified plastic surgeon in Charlotte. “It takes about 50-75 units of Botox, which is about twice the usual aesthetic does. And as it turns out, 60 percent of patients with migraines get a decreased frequency of migraines and a decreased severity.”

BOTOX COMES TO THE RESCUE WITH FACIAL NEURALGIA
Can you imagine having a condition whereby anything touching your face will ignite searing pain? Facial neuralgia affects some, and Botox is helping here, too.

“I had a close personal friend who had severe facial neuralgia and couldn’t find relief,” says board certified plastic surgeon Dr. Mark D. Epstein of Long Island. “His pain was so severe that when he was in the shower, it felt like his face was on fire. He couldn’t drive and it was impacting every aspect of his life. I told him we’ll try Botox and see how you do and the change was dramatic.”

BUT WAIT! THERE’S MUCH MORE IN THE BOTOX BAG OF TRICKS
“Another unusual use of Botox is for patients who have bruxism,” says Peter B. Fodor, MD, a board certified plastic surgeon in Los Angeles and Aspen. “This is a medical name for people who grind their teeth. What happens with patients with bruxism is that they have this muscle so well developed that they have faces that become rectangular in shape. They don’t like these bulges, so an injection of Botox helps with two things. You help them in terms of function because their grinding reduces significantly. Many of them don’t have to use a night guard anymore. And another thing you accomplish is the shape of the face changes from a rectangular shape to an oval shape. An oval shape is a sign of youth.”

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