The bacterium behind Botox was first identified in 1895 after an outbreak of food poisoning traced to spoiled ham in a small Belgian village. More than a century later, we have turned something negative into a positive, and a purified version of this same substance is used in medical offices across the globe.
At U | 180 Medical Spa & Wellness, we want our patients to know as much as possible about the treatments that we offer. One thing our patients may not know is that Botox has medical applications that came before its cosmetic uses. It is a product with a long history and ever-expanding repertoire.
The History of Botulinum Toxin as Medicine
Belgian bacteriologist Emile van Ermengem first isolated Clostridium botulinum in 1895 and connected it to a form of paralysis caused by contaminated food, called botulism. After this, scientists spent the following decades studying how the toxin shut down muscle activity.
Herman Sommer purified it into a stable form in the 1920s at the University of California. By the 1970s, ophthalmologist Dr. Alan Scott was injecting tiny doses into primates to correct misaligned eyes. His product, originally called Oculinum, was later acquired by Allergan and renamed Botox in the early 1990s.
What Was the First FDA-Approved Use of Botulinum Toxin?
In 1989, Botox was approved for strabismus, where the eyes are misaligned, and blepharospasm, an involuntary eyelid twitch that can force the eyes shut. Cosmetic approval did not come until thirteen years later, after blepharospasm patients noted that the lines between their brows had softened after Botox treatments.
How Botox Works
The muscles in your face contract when nerve endings release a chemical messenger called acetylcholine that tells them to move. Botox blocks this release, so the signal never reaches the muscle, which stays relaxed until the nerve endings grow back, about three to four months after treatment.
Sweat and salivary glands also need acetylcholine to work properly. Because of this, it can be used in other areas to reduce unwanted sweating and drooling, as well as movement. The effect is local to the injection site and reverses on its own.
Other Medical Uses of Botox
Chronic Migraine Prevention
The FDA approved Botox in 2010 to prevent migraines in adults with chronic migraine, defined as fifteen or more headache days per month. The PREEMPT trials were published in Cephalalgia. They found that injections every twelve weeks reduced headache days significantly compared to a placebo. Botox migraine treatments involve around 31 injections across seven muscle areas of the head and neck.
Hyperhidrosis Treatment
Excessive underarm sweating that does not respond to prescription antiperspirants has been treatable with Botox since 2004. Injections into the skin block the nerve signals that switch on sweat glands. A one-year prospective study of 81 patients found sweat production dropped from 0.81 grams to 0.23 grams per fifteen minutes, with quality of life scores improving alongside it. Results in the underarms typically last four to six months.
TMJ Pain Relief
Jaw clenching and teeth grinding overwork the masseter, the thick muscle along the back of the jaw. Injections weaken that muscle enough to reduce the strength of clenching, which eases jaw pain and other symptoms like morning headaches and tooth wear. This use is off-label but widely practiced. Botox can also create a slimming effect in the lower face as the over-large muscle atrophies, which some patients see as a bonus cosmetic effect.
Cervical Dystonia
Cervical dystonia causes the neck muscles to contract involuntarily, pulling the head into an abnormal position and creating persistent pain. Botox received FDA approval for this condition in 2000. Injections into the specific muscles pulling hardest reduce the contractions and improve head position for several months at a time.
Overactive Bladder
The bladder is a muscle, and it can contract when it isn’t supposed to. Botox injections into the bladder wall reduce urgency, frequency and leakage in patients who have not improved with medication. The FDA approved this use in 2013. A urologist administers the injections through a cystoscope, and results usually last six to eight months.
Upper Limb Spasticity
After a stroke, a spinal cord injury or in conditions such as cerebral palsy, muscles in the arm and hand can stay locked in contraction. Botox injections into the affected muscles reduce stiffness and make it easier to open the hand, position the arm and complete physical therapy.
Chronic Sialorrhea
Some neurological conditions, including Parkinson disease and ALS, interfere with swallowing and cause saliva to pool and spill. Botox injected into the salivary glands reduces saliva production. The FDA approved this use in 2018 to help with skin irritation around the mouth and lower the risk of saliva entering the airway.
How Is Medical Botox Different From Cosmetic Botox?
The vial contains the same active ingredient in both, but the dose changes, as well as the target of the injection and who administers it. Cosmetic treatment of frown lines takes around 20 units, while chronic migraine treatments use 155 to 195 units. Some conditions can require even more for good results. Medical injections focus on deep muscles, glands or the bladder wall, and many require the use of imaging to ensure the right injection points. Cosmetic injections stay in the superficial facial muscles.
What Are the Cosmetic Uses of Botox?
Botox is used both on and off label for lines and wrinkles. The FDA has approved treatment of forehead lines, frown lines, and most recently, platysma bands in the neck. Off-label, Botox can treat descending brows, bunny lines, a gummy smile and chin dimples. At U | 180 Medical Spa & Wellness, we start with a consultation so we can go over all of the ways we use Botox at our practice and create a treatment plan that is unique to you.
Learn More About Botox With a Consultation in Winnsboro, LA
U | 180 Medical Spa & Wellness serves patients in Winnsboro, Monroe, Columbia, Delhi, Tallulah and Sicily Island, offering injectables alongside bioidentical hormone replacement therapy, dermal fillers and medical skin treatments. Our injectors evaluate muscle strength and facial structure before recommending a plan. Call 318-412-2261 or use our online form to schedule a consultation.
