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Botulinum Toxin A: From Sausage Poison to Anal Fissures

Botox injection is the most popular cosmetic treatment in the United States. With over 4 million treatments performed last year alone, Botox cosmetic treatments have grown over 420 % since 2000, making it also the most significant growth sector. Although many people know that Botox is short for botulinum toxin, few people know the history or full uses of this unlikely medical minor miracle.

Botox History

Botulinum toxin was first described in the early 19th century as a poison occurring in badly handled meat products and derives its name from the Latin "botulus," meaning "sausage." It was considered for homeopathic use during the nineteenth century, but organized research into its medical utility did not occur until after it was discovered that the poison works by blocking neuromuscular signals.

Once this action was described, scientists began research on using one of the seven types of the toxin (type A) to treat spasms and other muscle disorders. The first organized investigation was into the treatment of strabismus (crossed eyes).

Medical Uses

After animal trials, the US Food and Drug Administration (FDA) approved the use of botulinum toxin type A for use in treating strabismus and blepharospasm (eyelid spasms) in 1989. Allergan decided on the trade name BOTOX for its version of this medical version of the toxin. Another major trade name used for the toxin is Dysport, although this has not been approved for use in the United States.

In 2000, the FDA approved the use of Botox for cervical dystonia (CD), a condition that causes spasms and tightening in the neck muscles, causing neck and shoulder pain and undesirable, uncontrollable movements of the head and neck. CD is sometimes called spasmodic torticollis.

Botox Cosmetic

Like so many medical advances, the use of botulinum type A for cosmetic purposes was somewhat serendipitous as doctors using the medical version of Botox discovered that it also had the effect of smoothing wrinkles around the eye, especially frown lines between the eyes, known as glabellar lines. This effect was described in medical journals in 2002, the same year it was approved for cosmetic use by the FDA, although it was being used off-label as a cosmetic treatment as early as 2000.

Continuing Innovation

The success of Botox cosmetic and collagen injections led to the investigation of a number of injectable treatments, especially hyaluronic acid-based fillers, such as Restylane.

In addition, Allergan continues to look for new applications for Botox. In 2004, Botox was approved for the treatment of severe underarm sweating (hyperhidrosis). It is also being investigated for use in the treatment of everything from temporomandibular joint disorder (TMJ) to anal fissures.

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