Tips on Alternative Uses for Botox®

By Cybele Fishman, MD

When most people think of Botox®, they think of it as a treatment that smooths forehead wrinkles with the goal of enhancing appearance, perhaps in an attempt to turn back the clock. Injections of Botox® and other similar products have become the most popular non-invasive cosmetic procedure, but these neurotoxins also have a wide range of other uses, both cosmetic and therapeutic.

Since Botox® was approved almost thirty years ago, the medical community has found that the mechanism that makes it so effective in treating wrinkles and lines is equally effective in treating conditions as varied as chronic migraines, excessive sweating, and eye spasms. What these disparate conditions have in common is that they are caused by the action of muscle cells, which are found throughout the body. Botox® acts on muscle cells and, as we’ve learned over time, there are almost endless applications for its beneficial effects.

The active ingredient in Botox®, “botulinum toxin A”, is a naturally-occurring toxin that works by blocking the interaction between nerve and muscle cells, temporarily paralyzing the muscle cells and preventing them from contracting. In its most popular usage, for facial wrinkles, a Botox® injection temporarily weakens the muscle cells that control facial expression causing the muscles to relax, contractions to diminish, and the skin to become noticeably smoother. In large doses, this toxin is responsible for botulism, which can cause paralysis and even death, but in tiny doses injected by a licensed medical professional, Botox® and similar products safely reduce the muscle contractions that produce undesirable effects. 

While Botox® and similar products continue to grow in popularity as the “go-to” treatment for facial wrinkles and lines, we continue to develop new and innovative uses that address cosmetic and medical concerns in surprising ways. Here are just a few of them:

• Chronic migraines: In 1992, a plastic surgeon in California noticed that his patients who had been given Botox® injections for forehead wrinkles reported fewer headaches. The drug was later tested on people with chronic migraines and was approved for that purpose in 2010. Sufferers who experience migraines fifteen or more days each month are given multiple injections in targeted areas of the head and neck; the preventive effect lasts about three months.
• Excessive sweating (hyperhidrosis) can be caused by genetics, stress, or exercise. Wherever it occurs on the body – underarms, scalp, forehead, palms of the hands, soles of the feet – it can be uncomfortable and embarrassing. Injection of a neurotoxin like Botox® into these areas blocks the transmission of signals to the sweat glands and stops the release of excess sweat. 
• Eyelid twitching (blepherospasm) can be incessant and can affect the upper, lower, or middle part of the eyelid. Botox® injections relax the muscles around the eye and reduce spasms.
• Crossed eyes (strabismus): Using Botox® to relax the muscles around the eyes and correct their alignment was one of the first approved therapeutic uses of the drug. Its effects last three to four months and are often as effective as surgery.
• Neck spasms: A condition called cervical dystonia, characterized by abnormal head position and severe neck pain, is caused by the neck muscles contracting involuntarily. Botox® works by blocking the nerve signals from reaching the affected muscles, thus preventing the involuntary spasms.

There are many more proven uses for Botox®. Its use for cosmetic purposes also extends well beyond the treatment of forehead wrinkles to include crows’ feet around the eyes, frown lines between the eyebrows, lines around the corners of the mouth, neck bands, sagging eyebrows, and more. Whatever its application, Botox® must be administered by a licensed, experienced doctor who will advise you on what will work for you and will use the utmost care in ensuring that you achieve your goals. I also advise to being careful of Med Spas where Botox is offered very inexpensively. Often this is because they are using fake Botox or it’s from sources where quality is not assured.

BOTOX® is a registered trademark of Allergan, Inc., an AbbVie company.

Cybele Fishman, MD, is a board-certified dermatologist, a fellow of the American Academy of Dermatology. She is in practice at Advanced Dermatology PC at 111 Broadway, Suite 1000 NY NY 10006.

Advanced Dermatology P.C. and the Center for Laser and Cosmetic Surgery (New York & New Jersey) is one of the leading dermatology centers in the nation, offering highly experienced physicians in the fields of cosmetic and laser dermatology as well as plastic surgery and state-of-the-art medical technologies. www.advanceddermatologypc.com.