Although the majority of attention botulinum toxins receive is for creating more youthful faces, the medical uses of these drugs are becoming increasingly popular. This seems logical since the original uses were medical, and the cosmetic benefit was an afterthought.
Currently there are two types of botulinum type A toxins approved in the United States. These are Botox (made by Allergan) and Dysport (made by Ipsen). Both of these proteins act by relaxing muscles, and although they are most famous for their cosmetic uses, they are more widely used for medical and therapeutic indications.
These medications are freeze-dried powders when they arrive at the physician’s office. The proteins decrease the communication between the nerve and the muscle where they are injected, thus, their range of action is limited. Commonly, the effects last for about three to four months.
Their use in medicine has been well studied and documented for more than 20 years. They are among the most researched molecules in medicine and their ability to treat a variety of medical problems is virtually unique. A recent New England Journal of Medicine article about botulinum toxins listed more than 20 different uses for these proteins.
Muscle Spasms
One of the most frequent non-cosmetic uses for these proteins is to treat muscle spasticity. This muscle spasm may be the result of damage from a stroke, traumatic injury, spinal disk disease, or cerebral palsy.
In each of these situations, the tightness of a muscle group limits mobility or causes pain. Botulinum toxins relax the muscle, often with dramatic improvements. I have several patients who have had muscle spasms following a neck or back injury, and injections into the affected areas have provided dramatic relief.
Headaches
Botox and Dysport can also ease headache pain, whether migraine or other types. I began to see this about 10 years ago while treating women for their frown lines.
After injecting 25 units of Botox, many of these women who suffered from migraines had relief for the first time in years. Most return like clockwork every three months for follow-up treatments.
In my experience, women who have migraines that begin in the front part of their head tend to do the best with these injections, but I have also seen good results for headaches that originate on the sides of the head.
I am not able to predict who will benefit from treatment with botulinum toxins for headaches but for those people who suffer from them and for whom regular medications are either not effective or too fraught with complications, I recommend speaking with someone who does a lot of injections to see if it a reasonable treatment option.
Sweating
Sweating is a normal human response that provides cooling for the body. However, for some people, it is abnormally active and this can have significant social and professional implications.
The costs in both time and money for dealing with increased sweating are also substantial. For these people, injections with botulinum toxins may help them to have more productive lives.
Transmission to the sweat glands can be efficiently interrupted by this protein, and the results last for between three to six months.
I treat patients who have overactive sweating (hyperhidrosis) that affects their forehead, palms, soles, and armpits. For some, this is a life-altering treatment.
Topical forms of these proteins are being tested, and at least one company (Revance) has published initial data demonstrating the safety and efficacy of a topical treatment.
TMJ
Temporal Mandibular Joint (TMJ) disease can be disabling for those affected by it. For some, injections of botulinum toxin into the jaw muscle can help to decrease clenching and minimize the symptoms.
This injection can weaken other muscles in the area, particularly those that are responsible for smiling, and the appearance from this may be unsettling.
However, as with the beneficial effects, the adverse ones are not permanent. I recommend a trial of this for people who have problems clenching their teeth or grinding them at night.
It is important to note that most of the uses discussed in this article are not approved by the FDA and are considered “off label.”
To learn more about Dr. Beer, visit www.idealskin.com and www.palmbeachcosmetic.com.
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