BOTOX®: A History

Before and after
This case shows the efficacy of BOTOX® on existing lines and wrinkles.

Familiar to modern patients as an injectable treatment for lines and wrinkles, BOTOX® has a long history and a variety of other uses. In fact, BOTOX® was originally developed as a treatment for neuromuscular conditions when scientists discovered botulinum toxin’s usefulness as a therapy for controlling or alleviating muscle spasms. Although these days BOTOX® Cosmetic is most often seen in medical spas, there are still many other medical conditions that can be treated with this injectable.


In the years following the World War II, medical innovation expanded by leaps and bounds as the U.S. industrial complex boomed in the post-war years and prosperity returned to America. Among many discoveries from this period of medical history is the first recorded use of botulinum type A to control muscle spasms in 1953.

After demonstrating continued success as a treatment for people suffering from uncontrollable muscle spasms, the 1960s brought further research and development of botulinum toxin for therapeutic medical uses. BOTOX® demonstrated excellent possibilities for ophthalmologists as a treatment for strabismus (crossed eyes) and blepharospasm (unmitigated and uncontrollable blinking).

1978 marked the FDA’s approval of botulinum toxin type A for use in clinical tests on humans. In the decade that followed, additional research was conducted into ophthalmic uses and for treatment of spasms of the trunk, face and even vocal cords. Allergan developed the well-known proprietary formula and popularized it under the name BOTOX®. The injectable was originally approved by the FDA for use as a treatment for cervical dystonia (abnormal head positioning causing severe neck pain).

BOTOX® as a Wrinkle Preventative

Prior to FDA approval, a Sacramento-based plastic surgeon, Dr. Richard Clark, discovered and documented the effects of botulinum toxin type A on wrinkles. He published his findings in the medical journal Plastic and Reconstructive Surgery in 1989. After this initial study, further trials found uses for BOTOX® as a solution for frown lines and other facial wrinkling.

BOTOX® Cosmetic as we know it – principally as a treatment for moderate lines and wrinkles – did not hit the market until 2002, when the FDA approved BOTOX® for cosmetic purposes. While BOTOX® Cosmetic is the same formulation that physicians use for muscle spasms and other neuromuscular conditions, there are specific dosing instructions for the injectable’s use as a wrinkle treatment in the med spa context.

Other Medical Uses

As BOTOX® grew in popularity, the medical community discovered more uses for the drug as a treatment for hyperhidrosis (excessive sweating) and upper limb spasticity (inability to reach or maintain muscle stiffness in the wrist, fingers, and elbows). BOTOX® also shows significant promise as a solution to the especially difficult problem of migraines, particularly for adults unable to find relief from other sources. In fact, BOTOX® is the very first drug to be FDA approved especially for the prevention of headaches in chronic migraine patients.

BOTOX®: The Future

For a drug with so many different uses already, it’s surprising that there are still more possibilities that are in clinical development or trials. BOTOX® is now being studied as a potential weight loss aid when injected into the muscles of the stomach to help suppress or control appetite. Neurotoxin therapy also shows promise as a new treatment for depression and chronic pain syndromes.

Perhaps most exciting is the forthcoming availability of topical formulas for BOTOX® Cosmetic and other injectable neurotoxin formulations currently in use. If successful, the creation and marketing of a topical neurotoxin may have many cosmetic uses such as controlling overactive sweat glands, sebaceous glands (oil glands), and even veins. It seems when it comes to BOTOX®, the future looks very bright indeed.