The following list provides some of the medical applications for botulinum toxin [1]:
- Dystonia
- Cranial dystonia
- Blepharospasm
- Lower facial dystonia
- Oromandibular dystonia
- Cervical dystonia
- Spasmodic torticollis
- Craniocervical dystonia
- Meige’s syndrome
- Laryngeal dystonia
- Spasmodic dysphonia
- Limb dystonia
- Sustained or fixed dystonia
- Task-specific dystonia
- Hemifacial spasm
- Tremor
- Tics
- Myoclonus, including palatal myoclonus
- Spasticity
- Multiple sclerosis
- Cerebral palsy
- Poststroke states
- Posttraumatic
- Ophthalmologic conditions
- Strabismus
- Acute oculomotor nerve palsy
- Nystagmus
- Masseteric hypertrophy
- Anal fissure
- Anismus
- Detrusor sphincter dyssynergia
- Achalasia
- Bilateral primary axillary hyperhidrosis [9]
- Brow furrows and frown lines
|
Fig. 5.2. Relaxation of the frown
lines in a woman and man treated
with Botox Cosmetic: before
treatment and 4 weeks following
treatment of the corrugator
supercilii and procerus muscles |
In 1991, Carruthers and Carruthers reported at the annual meeting of the American Society for Dermatologic Surgery the use of botulinum toxin injections for glabellar rhytids. In 1992, Borodic et al. noted a decrease in facial wrinkling in the course of treating individuals with hemifacial spasm [10]. Such observations led to interest in botulinum toxin for treating rhytids. Since that time, additional research has been undertaken to explore its usefulness to treat hyperkinetic movement disorders as well as its capacity to reduce hyperkinetic glabellar facial lines.Numerous studies were undertaken in the mid-1990s; for example, one study evaluated the protein’s ability to ameliorate facial kinetic frown lines [7] while a double-blind, placebocontrolled investigation evaluated its efficacy to treat glabellar folds [11]. A collaborative study of 210 injection sites in 162 patients showed the natural purified protein to be a safe and important adjunctive technique for the management of patients with symptomatic hyperfunctional facial lines [12].
Today, treatment of rhytids with botulinum toxin is the top nonsurgical procedure in the United States with over one million people injected. Demographics indicate that the volume of treatment will increase, as baby-boomer statistics reveal a large market with considerable financial assets: 78 million people aged 36–54 years old (born between 1946 and 1964).While only 29% of the US population, this segment controls 74% of personal financial assets (Allergan). This large market is driven by women in their 40s who have become self-aware of their aging, find that managing appearance is more urgent, and desire more than ever to take care of themselves (Fig. 5.2).
