Botox Nation: How One Drug Fixes So Many Problems

May 25, 2006 — -- Overactive bladder, diabetic nerve pain, excessive sweating, migraine headaches, voice tremors -- these are just a few of the conditions that the drug Botox can treat.

This week came the news that yet another condition might be alleviated by Botox -- benign prostatic hypertrophy, or prostate enlargement.

Botox's manufacturer, Allergan, says that it is one of the most used medications worldwide, approved for 20 problems in more than 75 nations. This list will likely grow as new discoveries are made.

How did one drug -- which was originally approved to treat excessive blinking back in 1989 -- become so useful? The answer lies in how Botox can be injected directly to the source of the problem -- usually an overactive muscle, gland or nerve connection -- with few lingering side effects, making it easy for scientists to experiment with it on different problems.

"Every group of physicians that have taken on botulism A have found innovative uses for it," said Dr. Alastair Carruthers, a clinical professor of dermatology at the University of British Columbia. Carruthers is also half of the husband-and-wife team that first reported Botox's cosmetic use in the 1990s.

Botox comes from the botulinum toxin produced by the Clostridium botulinum bacteria. If ingested in large amounts, such as from eating infected food, it can cause a deadly infection that works by paralyzing muscles -- including the heart.

But, in very small doses, the toxin has a therapeutic effect by preventing nerves and muscles from "talking" to each other, relaxing the muscle for a period of time.

Initially, the Food and Drug Administration approved Botox to treat excessive blinking, known as blepharospasm, and strabismus, or crossed eyes. It didn't take long for Carruthers' wife, ophthalmologist Jean Carruthers, to notice Botox's most well-known potential -- a "wrinkle eraser."

That's because one of Carruthers' patients asked to continue treatment even after her eye tremors had stopped -- because it relaxed a wrinkle on her brow. Word got out, and by 2002, the FDA had approved Botox for wrinkles, initiating the plastic surgery craze for it.