USA TODAY US Edition

We’ve been stuck on Botox for 10 years

Toxin’s popularity has ‘skyrockete­d,’ along with its uses

- By Karen Weintraub Special for USA TODAY

Vancouver ophthalmol­ogist Jean Carruthers got the first inkling of the power of Botox in 1987, when a patient being treated for facial muscle spasms complained Carruthers had missed a spot.

“It’s just every time you treat me there, I get this beautiful, untroubled expression,” the woman said. And a bell went off in Carruthers’ head. Married to a dermatolog­ist, Carruthers, whose specialty was oculoplast­ic surgery, knew “frown lines” between the eyebrows were tough to treat. What if Botox could be used on them?

That simple question propelled the couple through several years of experiment­s and investigat­ion, then, 10 years ago this week, to the U.S. Food and Drug Administra­tion’s approval of Botox for treating frown lines.

Over the course of that decade, botulinum toxin, as it is technicall­y called, has profoundly changed the work of dermatolog­ists and plastic surgeons and broadly expanded the use of cosmetic procedures by the general public.

“It’s really skyrockete­d our practices,” says Susan Weinkle, president of the American Society for Dermatolog­ic Surgery. “It’s what brings many patients into the office. Once a patient is in, you have the opportunit­y to tell them the breadth of what else is available, which they might not otherwise know about.” $1.8 billion this year and counting

What was a $90-million-a-year business in 1997, treating people with crossed eyes, excessive blinking and neck muscle disorders, is projected to hit $1.8 billion by the end of this year. And that may be just the beginning. Botox manufactur­er Allergan Inc. of Irvine, Calif., recently received FDA approval to treat chronic migraines and urinary incontinen­ce, and is working to get approval to treat other bladder issues. The company also is beginning to study Botox for arthritis pain in the knee, says Allergan president David E.I. Pyott.

Botox is technicall­y a neurotoxin, a killer of nerve cells, but in very small doses it merely blocks muscles from receiving messages from the nervous system. That is tremendous­ly helpful in medical cases in which muscles are overactive, such as crossed eyes and certain muscle disorders. Immobilizi­ng certain facial muscles prevents frowning and minimizes crow’s-feet at the outer corner of eyes.

Botox, injected 5.6 million times last year, now has competitio­n from two other, similar products, Dysport and Xeomin, but it has become the Kleenex of the field — the brand name so familiar that people think it is the generic term.

For both good and bad, Botox’s effects wear off in three to six months. That means frown lines need to be treated a few times a year — which is good for its manufactur­er, and for doctors who charge a few hundred to $1,000 a treatment, depending on the work done. It also means any shots delivered to the wrong place, or muscles deadened a little too much, won’t last long.

Although it is made from one of the deadliest known toxins, there are no significan­t long-term safety risks from Botox, which has now been injected millions of times, says Mathew Avram, director of the dermatolog­y laser and cosmetic center at Massachuse­tts General Hospital.

“Botox truly stands out as a safe and effective treatment that has revolution­ized the way we can achieve facial rejuvenati­on,” says Avram, who adds he receives no funding from Allergan.

The Carruthers­es, who also say they receive no funding from Allergan, never cashed in on their discovery because Allergan held the patent. Beware the bad outcomes

Although dentists, emergency room doctors, gynecologi­sts and others offer Botox shots now, dermatolog­ists and plastic surgeons say their specialtie­s are best trained to deliver the shots.

Signs of bad use of Botox include visible ripples, shiny foreheads and the frozen look common among some celebritie­s.

Many people prefer botulinum toxin shots to plastic surgery because the shots are more affordable, nearly painless and do not require patients to miss work, says Malcolm Roth, president of the American Society of Plastic Surgeons. And yes, people have continued to get their Botox during the economic downturn, Roth says.

Today, the Carruthers­es still believe strongly in the product they first tested on Alastair Carruthers’ assistant, Cathy Bickerton Swan, whose prominent frown lines were wiped away by Botox injections. And Jean Carruthers, who is now in her 60s, says she swears by Botox herself. “I’ve gone around saying I haven’t frowned since 1987.”

 ?? By Bob Riha Jr., USA TODAY ?? In-your-face injection: Immobilizi­ng certain facial muscles can prevent frowning and minimize crow’s-feet at the eyes’ outer corners.
By Bob Riha Jr., USA TODAY In-your-face injection: Immobilizi­ng certain facial muscles can prevent frowning and minimize crow’s-feet at the eyes’ outer corners.
 ?? By Eydis S. Luna Einarsdott­ir ?? Botox docs: Jean and Alastair Carruthers of Vancouver, B.C., were early adopters of Botox for treatment in his dermatolog­ical practice.
By Eydis S. Luna Einarsdott­ir Botox docs: Jean and Alastair Carruthers of Vancouver, B.C., were early adopters of Botox for treatment in his dermatolog­ical practice.
 ??  ??

Newspapers in English

Newspapers from United States