Although Botox has become synonymous with smoothing wrinkles, it’s had a surprising history and it is still used to treat some serious medical issues. Botox is made from the toxin produced by the bacterium Clostridium botulinum. The toxin causes certain muscles to become weakened by blocking the signals from nerves to those muscles.
The bacterium was first discovered in 1897 when a group of Belgians become ill after eating spoilt ham. It was then isolated and purified by US scientists during World War II and tests were conducted into its possible use over the following decades.
During the 1970s, an American ophthalmologist investigated its use in treating eye impairments such as retinal detachment and strabismus, more commonly known as crossed eyes. In 1987, a Canadian ophthalmologist using Botox to treat blepharospasm realised that an unintended side effect of the drug was that it smoothed the lines around the eyes. Jean Carruthers and her husband, a dermatologist, experimented further with Botox’s wrinkle relaxing effects, and published their first study in 1992.
Very quickly, botulinum toxin’s ability to smooth dynamic wrinkles made it much in demand and Allergan bought the rights to the drug in 1991 and rebranded it as Botox. By 2002, it had received FDA approval for the treatment of forehead lines, frown lines and crow’s feet. However, alongside its aesthetic uses, Botox still has many surprising and serious medical applications.
Botox and alleviating depression
In 2006, the first study was conducted into whether Botox could alleviate depression. In a very small-scale study ten patients with major depression were injected with Botox into their frown and when assessed two months later, nine out of 10 claimed they were no longer depressed and the tenth had experienced and ‘improvement in mood’.
Since then, further studies have investigated the connection and found a positive impact on patients with depression. Rather than it being the case that an improved external appearance is a mood-lifter, it’s believed that ‘facial feedback’ is the cause – basically, the act of frowning makes you unhappier. Another theory is that Botox in the forehead calms the amygdala which is the part of the brain that is activated when depressed.
Botox as migraine drug
In 1992, a plastic surgeon in Beverly Hills discovered that his Botox patients were also reporting fewer headaches. Allergan tested Botox on those with chronic migraines and it received FDA approval for this usage in 2010. It’s still not exactly proven how Botox alleviates migraines but it’s through that it blocks chemicals called neurotransmitters which carry pain signals from your brain.
It’s also now approved by the NHS in the UK for the treatment of chronic migraines in adults. Chronic migraine is defined as having at least 15 days a month where you experience headaches, of which at least eight feature migraine symptoms. Patients must have also tried at least three preventative treatments with no respite from symptoms. The UK’s Migraine Trust indicate that a good response to Botox is a 30-50% reduction in the number and severity of headaches.
Botox for the treatment of hyperhidrosis
Another use for Botox that’s received approval by NICE, the national body that provides healthcare guidance in the UK, is for the treatment of excessive underarm sweating. Botox doesn’t treat the underlying cause but, by temporarily blocking the nerve signals that trigger the sweat glands, it can reduce underarm sweat production. Studies have indicated it can reduce it by more than 50% for at least six months.
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