What was botox first used for

Spread of toxin effects. The effect of botulinum toxin may affect areas away from the injection site and cause serious symptoms including: loss of strength and all-over muscle weakness, double vision, blurred vision and drooping eyelids, hoarseness or change or loss of voice, trouble saying words clearly, loss of bladder control, trouble breathing, and trouble swallowing.

For more information refer to the Medication Guide or talk with your doctor. To report a side effect, please call Allergan at This website uses cookies and other technologies to personalize content and to show you more personalized ads for example, Google Ads and Facebook on this and other websites, as well as provide you with social media features on this website such as, Facebook, Twitter, LinkedIn. For a limited time, TIME is giving all readers special access to subscriber-only stories.

For complete access, we encourage you to become a subscriber. Click here. Now, thanks in large part to off-label use, Botox—the wrinkle smoother that exploded as a cultural phenomenon and medical triumph—is increasingly being drafted for problems that go far beyond the cosmetic. Botox is a neurotoxin derived from the bacterium Clostridium botulinum. Ingested in contaminated food, it can interfere with key muscles in the body, causing paralysis and even death.

But when injected in tiny doses into targeted areas, it can block signals between nerves and muscles, causing the muscles to relax. That noncosmetic revenue is likely to balloon in the years ahead as doctors try out Botox for even more off-label uses and as Allergan conducts studies of its own. Most of the experts I spoke with agree that in small doses, Botox is safe when administered by a licensed professional, but not everyone agrees that its safety extends to all of its newer off-label uses.

It highlights the advances that can occur when physicians, seeking new therapies for their patients, explore creative new uses for approved drugs—basically, real-world experiments that take place largely beyond the reach of federal regulators. That, in turn, raises questions about the risks of deploying medicines in ways that have not been fully vetted.

But it happens all the time. The drug has come a long way since its ability to smooth facial wrinkles was first discovered, by accident. In the s, ophthalmologist Dr. Alan B. Scott started studying the toxin as a therapy for people with a medical condition that rendered them cross-eyed. Scott named the drug Oculinum and formed a company of the same name in In he received FDA approval for the treatment of strabismus the crossed-eye disorder and abnormal eyelid spasms.

In , David E. Pyott became CEO of Allergan. In , Botox earned FDA approval for so-called frown lines—wrinkles between eyebrows—marking the first time a pharmaceutical drug was given the green light for a strictly cosmetic purpose.

In just over a decade, the number of people in the U. It became a cultural phenomenon too, spawning Botox parties, Simpsons jokes, even greeting cards. Now Botox, on the other hand, that works every time. During that period, he and his colleagues developed Teflon-insulated needles to locate and paralyze eye muscles to treat strabismus, the crossed or other misalignment of the eyes.

That condition afflicts as many as 4 percent of Americans. They joined with colleagues to publish a study last year with a grant from the National Institutes of Health and other sources showing that the drug bupivacaine -- a local anesthetic -- could strengthen the eye muscle opposite the muscle that was weakened by Botox. They found strabismus was successfully corrected in two-thirds of patients tested.

Scott said those results are encouraging and will replace surgery for many patients. Studies in children with strabismus to get just the right dose of bupivacaine and to see long-term effects are just getting under way.

Bupivacaine can stimulate eye muscles in a manner that he compares to lifting weights. In addition to strabismus, Botox has been a godsend to sufferers of benign essential blepharospasm, a neurological condition in which the eyes involuntarily force themselves shut, by stopping the muscles from going into spasm.

Blepharospasm affects an estimated 20, to 50, Americans; for some unknown reasons, women are twice as likely to suffer from it as men.

Scott remembered how the first blepharospasm patient he treated in had her eyes so tightly clamped that her husband had to guide her into his office. He injected Botox into the center of her eyelid and was ecstatic to find the next day that the eyelid was wide open — only to discover the day after that that it had re-drooped. That experience taught him to keep the upper eyelid doses at the margins and to the sides of the eyelids and to keep the doses low. These days, Scott is developing a method of treating sufferers of blepharospasm with tiny implanted devices that perform pacemaker-like stimulation of the eyelid muscles to hold the eyes open.

The views expressed are those of the author s and are not necessarily those of Scientific American.