Ask The Doctor: Botox Beyond Cosmetic Surgery
When you think of Botox, what’s the first thing that comes to mind? Cosmetic surgery? Today, we view Botox as a way to enhance or alter our physical appearance.
But, can Botox go beyond cosmetic purposes and be used as a solution for other health-related problems? We asked Robert W. Bragdon, M.D. to find out:
Q: Botox has long been used by plastic surgeons for cosmetic purposes, but are there other uses in health care?
A: Botox is onabotulinumtoxinA, a highly purified version of the neurotoxin which is commonly associated with food poisoning, or botulism. It was originally developed to treat ocular problems like strabismus, in which a patient’s eyes don’t look in exactly the same direction at the same time. It also was used for blepharospasm, a neurological condition involving forcible closure of the eyelids. Simply put, Botox works by blocking signals between nerves and muscles.
Botox treatments, as well as other “injectables,” have become the most common procedures performed by plastic surgeons in the United States. Botox for cosmetic purposes was developed to weaken the muscles which cause creases between the brows, frequently called “the 11s,” as well as forehead creases. As a result of the muscles not being contracted as frequently, or forcefully, those creases smooth out, making lines less evident or refreshed. When used for cosmetic purposes and improving one’s appearance, the benefits of Botox primarily revolve around a feeling of better self-esteem and well-being, which are the desired outcomes for any type of aesthetic procedure or therapy.
Interestingly, as a result of these cosmetic treatments, some patients who suffered from migraine headaches noted relief of their headache symptoms following Botox injections. This led some physicians to start using Botox to treat migraine headaches.
Other so-called “off-label,” or non-FDA-approved, applications for Botox include treating back pain, depression and teeth grinding, among others.
But the growing list of FDA-approved uses for Botox include hyperhidrosis, or excessive sweating of the underarms and the palms of the hands, particularly when topical agents are no longer effective.
And some specialists incorporate the use of Botox in treating muscular disorders involving spasticity of the upper extremities, as well as the neck. It has also been utilized for symptomatic relief of urinary incontinence and overactive bladder.
As always, though, there are contraindications to any type of procedure, so patients need to inform their physicians of all medications and supplements they are taking and any type of neuromuscular disease they might have prior to commencing any type of treatment with Botox, whether that treatment is FDA-approved or off-label.
This story is an edited version of a full report published in our Spring 2017 edition of HouseCall. If you want to read the full write-up — which includes more information — you can visit the St. Clair website and download a copy of our Spring 2017 HouseCall here.