Vancouver ophthalmologist Jean Carruthers and her husband, Alastair Carruthers, a dermatologist, are credited with pioneering the cosmetic use of botulinum toxin, or Botox, in the late 1980s. This neurotoxic protein was first discovered by Belgian scientist Emile Pierre van Ermengem after an outbreak of botulism in Belgium. In the 1920s, scientists at the University of California, San Francisco, attempted to isolate botulinum toxin, but it was not until 20 years later that it was finally isolated in crystalline form by Dr. Norman Rosenthal. Botulinum toxin (BoNT) is produced by the bacteria Clostridium botulinum and related species.
It works by preventing the release of the neurotransmitter acetylcholine from the axonal endings at the neuromuscular junction, thus causing flaccid paralysis. This toxin is used commercially for medical and cosmetic purposes. Jean Carruthers believes that new neurotoxins will give Botox a run for its money and fillers will be developed that not only fill the cracks but also encourage skin tightening. Bethenny Frankel is injected into the jaw to relieve symptoms of bruxism (grinding her teeth), and actress Kristin Chenoweth uses Botox to treat her migraines.
Dr. Norman Rosenthal, who recommended Botox for his suicide patient, has seen the setback firsthand. Women have been using botox injections since 2002 to tighten the skin and reduce signs of aging. Mitchell Brin, senior vice president of drug development at Allergan and chief scientific officer of Botox, found that about 70% of women treated with Botox reported an average of three leaks a day, compared to the average of five leaks a day at the start of the study. Botox has also been shown to prevent chronic migraines, but it's not clear exactly why it works. Eric Finzi, assistant professor of psychiatry at the George Washington School of Medicine, published a study showing that when people with major depression receive Botox, they report fewer symptoms six weeks later than people who were given placebo injections. Patients became desperate as Botox supplies were gradually consumed, forcing doctors to abandon patients who would have owed their next injection.
Most experts agree that in small doses, Botox is safe when administered by a licensed professional, but not everyone agrees that its safety extends to all its new unapproved uses. From fatal food poisoning and biological weapons to eye spasms and crow's feet, it almost seems ambitious to expect Botox to have more tricks up its sleeve. From a food-poisoning pathogen to a deadly biological weapon, botox finally found its popular use today as something completely different.