Putting a fresh face on Botox

February 4, 2009 – 1:27 pm by Michael Christel

Did you catch that promo for “Celebrity Apprentice” during the Super Bowl? For me, it immediately brought two things to mind – one, will Dennis Rodman and Scott Hamilton conspire to get Andrew Dice Clay “fired?” and, two, Joan Rivers’ face, at least in high definition, is pulled tighter than a baby on the subway. Of course, that’s no secret. The tuckered-out Queen of Comedy has long professed her love for Botox, plastic surgery, and the like. What may be less known, however (and, yes, I was getting at a point beyond the usual, “Hey, have you seen Joan Rivers’ face lately?”), is that Botox injections are increasingly being studied as a treatment for “real” diseases. Yesterday, it was reported that botulinum toxin could help combat the effects of psoriasis. A trial at the University of Minnesota will investigate. Could it be that Botox is giving lifestyle drugs a bad name?

Probably not, but it’s fair to say Botox does more than just smooth wrinkles. Here’s a nice summary of some of the drug’s other uses, including treating migraines, excessive sweating, and even enlarged prostate. The evolution of Botox is particularly interesting as doctors apparently discovered its cosmetic wonders by accident.

Botox, a muscle relaxant, has also been used to decrease spasticity related to multiple sclerosis and other neurological conditions, including “shaky hands,” a symptom of essential tremor. FDA has not yet approved Botox for these conditions. In September, according to published reports, Botox manufacturer Allergan Inc. said two large human studies of the drug demonstrated benefit for adults who suffer from chronic migraines. Allergan, at the time, said it would ask FDA this year to expand approval for the drug to cover chronic migraine.

Of course, Botox’s appeal remains predominately in aesthetics. In fact, the cosmetic-procedures market has managed to maintain a strong face amid the swirling economic winds. According to The Wall Street Journal, nearly three out of four plastic surgeons who responded to a survey last fall reported that, despite the financial crisis, demand has increased or held steady for minimally invasive procedures, including Botox. UPDATE: Apparently that trend has suffered in recent months. Allergan has reported that sales of Botox – both for cosmetic and therapeutic use – dropped about 3% in the fourth quarter of 2008 compared to the same period the year before. Meanwhile, Allergan’s sales of skin-plumping injections – called dermal fillers or facial fillers – fell almost 9% in the fourth quarter, according to a New York Times report, and the company’s sales of breast implants plummeted a whopping 12%.

“You could forecast that with implants, but the bigger question was, ‘How have injectables been holding up?’ ” Gary Nachman, an analyst with Leerink Swann, told The Times. “Now, even the injectables have been impacted significantly.”