Very long term effects of Botox still unknown

November 21, 2002

The use of botulinum toxin for facial cosmetic enhancement has established its new image as a glamour drug, but its unlicensed use is increasing dramatically for certain conditions, ahead of clear scientific evidence. Although negative side effects are few, its very long term effects are still unknown, warns a neurology expert in this week's BMJ.

Botulinum toxin is reported to be useful in more than 50 conditions, but is licensed for only a few. For instance, in the United Kingdom it is an effective and safe treatment for facial spasms and excessive sweating, with few side effects. It may also be useful in several conditions for which it does not yet have a licence. In the United States the toxin was licensed this year for facial lines or wrinkles.

The revenue for the global sales of Botox has increased from $25m in 1993 to $310m in 2001 and is estimated to be $430m in 2002, writes the author. The biggest area of growth has been in dermatology - the use of the toxin for facial lines has increased by 1500% in the United States over the past four years.

Popular magazines and newspapers regularly report its use by celebrities from the film, television, and music industries. Given such hype it is unsurprising that a recent study found that 23% of patients seeking treatment with botulinum toxin at a dermatology clinic had body dysmorphic disorder, and psychotherapy was considered the more appropriate treatment for them.

In this atmosphere of "Botox parties," it is easy to forget that botulinum toxin is a potent neurotoxin and that its very long term effects are still unknown, he concludes.
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BMJ

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