I doubt there are many people with an interest in cosmetic medicine that have not followed the success story that is Botox. Botulinum Toxin type A (BTX-A)-the active medication in Botox- was developed as a medical treatment for strabismus-an eye disorder-first being used in 1968 by Dr. Alan Scott in San Francisco. In 1991, Allergan purchased the rights to BTX-A and marketed the product under the brand name, BOTOX. Other uses for Botox in treating different eye disorders followed but it was when Botox was found to improve some types of facial wrinkles associated with aging that Botox really took off. Every year in the United States alone, there are hundreds of thousands of treatments using Botox for cosmetic reasons and this number keeps getting larger every year.
While Botox’s success is remarkable, there still are many patients who could potentially benefit from Botox but who will not do so because of one fear; the fear of needles. Botox treatments currently require giving a series of very small injections in order to deliver the Botox medication to the target tissues. For those needle-phobic patients, there may be help on the way. Glougau et al reported in Dermatologic Surgery recently the development and application of botulinum toxin type A (BTX-A) in a topical form-that is in a form of the medication that is applied to the skin and not by injections. The study looked at using BTX-A in a topical compound which was applied to the underarm area of patients for treating axillary hyperhidrosis-a condition of excessive underarm sweating. The study results demonstrated significant reductions of underarm moisture on the treated side when compared to the placebo side. This first study was very small in size but the potential for using BTX-A in this manner is huge-just ask any bride in a strapless bridal gown. While topical BTX-A applications have a long way to go before they achieve FDA approval, I am sure that once the topical BTX-A medical products are developed and approved, we will see another “boom” in the use of Botox and its cousins.
Herluf Lund MD