Much has been written about its misuse or overuse and concerns have been raised over the qualifications; training and technique, or lack of, of those who are doling out Botox injections at salons, spas and even in homes across the nation.
It’s revered, it’s reviled and despite the occasional side effects (droopy eyelids, slopey eyebrows) and those countless frozen-faced stars, you have to admit — Botox remains the number one go to for those who want to regain that smooth glowing look and counter the effects of ageing.
Many may wonder where does it come from; its origins and how it was discovered etc.
So let’s take a historical look at The Botox Journey through time-
Dr. Emile Pierre (from Belgium)It was in the 1890s when Dr Emile Pierre Van Ermengem (from Belgium) was called in to investigate an outbreak of Botulism following a funeral dinner where a few people had died.
Dr. Robert KochDr Emile had studied under Dr Robert Koch (who discovered the bacterial causes of TB, Anthrax and Cholera) and was able to make a connection between Botulism and a spore forming bacterium he named Bacillus botulinus. His studies led to the discovery of 7 strains of Botulinum toxin out of which (A,B,E and F) were shown to cause illness in humans.
With the World War II in the 1940s, the U.S. started to research biological weapons, including Botulinum Toxin that was considered at this point to be the deadliest substance in the world. We do not have much in the form of evidence if this was used actively as a weapon but needless to say that this powerful toxin had taken centre stage by then.
It was in 1953, when physiologist Dr Vernon Brooks discovered that injecting small amounts (after Dr Edward Schantz and his colleagues earlier on were able to purify Botulinum toxin Type A into crystalline form) of this crystalline into a hyperactive muscle, blocked the release of acetylcholine (found in motor nerve endings) thus causing ‘relaxation’. In a few years Botulinum toxin Type A had become the ‘go to’ in research labs around the world even though there was a constant fear about its use in ‘biological warfare’!
It was not until 1978, when Dr Alan B Scott received FDA approval to test this in humans and soon various results showed the benefits of patients experiencing temporary relief from facial spasms, neck and shoulder spasms etc. In 1988 Allergan acquired the rights to distribute Scott’s batch of botulinum toxin Type A and in 1989, the FDA gave its approval for the treatment of strabismus and blepharospasm (eyelid muscle spasms). Soon Allergan bought over Scott’s company and changed the drug’s name to ‘Botox’ but the biggest discovery was yet taking shape.
It was in the early 1990s when a Canadian doctor Dr Jean Carruthers (ophthalmologist) noticed that her ‘blepharospasm’ patients had seen a disappearance of their frown lines. Along with her dermatologist husband Dr Alastair Carruthers they decided to test this internally on those with frown lines between the eyebrows and in 1992 presented their results to the American Society for Dermatologic Surgery stating the safe effects, and by 1993 it had a ‘snowball’ effect and soon dermatologists from everywhere starting to take note of this revolutionary drug.
By 1997, use of Botox had spiked high and the new millennium brought in a steady stream of FDA approvals. In 2002 Botox Cosmetic got its official go-ahead and Allergan began a multimillion dollar advertising campaign to boost the sales of Botox which had reached $300 million by 2001.
Fast forward a decade plus later and Botox has been profiled in numerous TV/Print stories, Allergan has proclaimed it as one of the most successful pharma brand launches in the company’s 50 + year history and Botox is everywhere. TV shows, cocktail parties, Hollywood, family gatherings, Aesthetic clinics, spas, salons and dentists.
Botox in the USA is considered the No. 1 Non-surgical cosmetic treatment and has gained its fair share of followers here in the UK as well with most dermatologists and aesthetic doctors being trained in it.
There is an effort by Allergan to modernize the brand with its latest target being the ‘millennials’ considering that Botox injections have increased by 22% among 22-37 year olds in the past few years according to the American Academy of Facial Plastic and Reconstructive surgery. Does this mean that the age of Botox users is now getting younger considering the average age for its core consumer is 46?
Are we yet to see another massive surge in Botox use in even younger adults given the current trend and emphasis on early care or ‘pre-juvenation’ as it has been termed? Only time will tell.
Botulinum toxin comes under various brand names and include Azzalure and BoCouture. So don’t panic if you see one of these names. Some practitioners actually prefer these over Allergan’s Botox.
You may be surprised to know that Botulinum toxin has many other medical uses such as in the treatment of migraines, bruxism (teeth grinding), overactive bladder and hyperhidrosis (excessive sweating).
Make sure whatever your reason to seek this treatment that you visit a medical professional. This is a prescription only drug and safe only in the right hands.
Possible side effects include redness, bruising and slight swelling at the injection area, temporary headache, dropping of the brows etc. Infections are very rare.
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Author: Dr Amit Goyal, Aesthetic Skin Doctor at MK Aesthetics is also a well established GP Partner at a prestigious surgery in Milton Keynes with an interest in Dermatology and is the lead GP for Dermatology in Milton Keynes. He is also part of the Dermatology team at Bedford Hospital.
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Tel: 01908 766276