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All About Injectables, part 2: Strange, Exciting and Surprising Medical Uses for Botox

Botox has been around since the 1970s and has quite a history. Its original name was Oculinum and its original use wasn’t intended for cosmetic purposes. Smoothing lines that was seen as a nice side benefit from patients who were being treated by the ophthalmologist who invented it to treat a medical condition causing strabismus (cross eyes). In 1991, two years after receiving FDA approval for treatment of strabismus and eyelid spasms, the company Allergan bought Oculinum and changed the name to Botox.

At first, Allergan didn’t even realize what they had their hands on, but as use grew and more discoveries were made by the doctors experimenting with it, a whole new world opened up in the cosmetic industry. Even today as Botox is most well know in the mainstream population for it’s wrinkle smoothing effect, Allergan holds more than 800 patents for its use, most of which are for helping with medical conditions. Here are some of those strange, exciting and surprising uses for Botox:

FDA Approved Medical Uses

  • Strabismus – Approved in 1989, this original use for injecting tiny amounts of botulinum type A helped correct the muscle issue causing crossed eyes.
  • Neck spasms – Approved in 2000 for the management of neck pain caused by an abnormal head position called cervical dystonia. This approval was before Botox was officially FDA approved for the cosmetic treatment of frown lines in 2002.
  • Excessive underarm sweating – Approved in 2004, for this condition, which is officially called primary axillary hyperhidrosis, is also used as a non invasive treatment for overly sweaty hands and feet.
  • Chronic headaches – Approved in 2010 for chronic migraines, use for headaches started with a plastic surgeon’s discovery that his patients who received Botox for wrinkles also reported less headaches.
  • Overactive bladder – Approved in 2013, the constant contracting of the bladder causes the need to urinate frequently or have leakage. When injected directly into the bladder muscle, Botox has been demonstrated to safely and effectively relax those muscles causing the problem with results lasting up to one year for a third of the study’s trial population.

“Off label” Medical Uses

  • Depression – After multiple successful small medical studies, Allergan is currently conducting clinical trials to confirm the results many doctors are finding for their patients who want an alternative to medications. The theory of how Botox affects mood is related to the “facial feedback hypothesis.” This hypothesis says that a person’s mood can be affected by their facial expressions, so therefore if their facial muscles are inhibited from frowning, mood improvement follows.
  • Abnormal heartbeat – Allergan is siezing an opportunity to help with an unmet medical need to help reduce postoperative atrial fibrillation, which occurs in 27 to 40 percent of patients. A promising small study with Botox conducted at Duke Medical Center demonstrated a lesser occurrence of an abnormal heart rate after heart surgery.
  • Sexual issues – Botox is being studied to treat erectile dysfunction, premature ejaculation and painful sex for women.
  • Cold hands – When Botox is injected into the hand muscles that surround constricted blood vessels, the resulting circulation improvement has been shown to provide up to 3 months of relief.

Botox is providing amazing help for a variety of medical needs, as well as cosmetic ones. You can read more about Botox for Bell’s Palsy here. It truly is a very exciting treatment.

Steven Davison M.D.

Board Certified Plastic Surgeon

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