(Botox: A Poisonous Path to Pretty)
By Patience Elett
Red dots indicate potential sites of Botox
injection for the relief of wrinkles.
Introduction
By Patience Elett
Red dots indicate potential sites of Botox injection for the relief of wrinkles.
Introduction
Who would have thought that injecting poison into certain parts of your body could help ease the pain that comes with some disorders? Who could have assumed that doing this could alleviate muscle spasms and essentially erase wrinkles? Scientists and ophthalmologists have experimented with the botulinum toxin since the 1820s and they have found multiple uses for this toxin originally found in bad or ill-prepared food. This neurotoxin (type A) is now what we know as Botox.
History
1820s
In the 1820s, noone really knew the biological cause for food poisoning until Dr. Justinus Kerner studied a basket of incorrectly prepared blood sausages that caused several dozen deaths in Germany. Kerner was so dedicated to his scientific career that he tested his experiments on himself, which made him sick. His experiments and studying cases of botulism outbreaks led him to a better understanding of the neurological symptoms of "food poisoning" (trouble swallowing, droopy eyelids, muscle weakness, and if untreated, respiratory failure and paralysis). He also made suggestions for prevention and treatment of food poisoning because of his extensive research and experimenting. He also gave us a path to the therapeutic use of that toxin.
1890s
Dr. Emile Pierre van Ermengem of Belgium was asked to investigate an outbreak of food poisoning at a funeral. Ironically, three people died, while 23 were paralyzed because of the bad ham someone brought. Van Ermengem was able to make a connection between botlism and a spore forming bacterium he had named Bacillus botulinus; later re-named Clostidium botulinum. Later studies revealed seven strains of the toxin (A-G). A, B, E, and F cause illness in humans.
1940s
When the U.S. got involved in WWII, the military started researching biological weapons, including the toxin that causes botulism. It's considered the deadliest substance in the world. One plan was to use Chinese prostitutes to put small toxic pills into the food and drinks of the superior Japanese officers. A batch of botulinum toxin filled gelatin capsules were made, but the plan was abandoned before poisoning the Japanese.
1950-60s
When WWII ended, researchers focused on the beneficial aspects of the botulinum toxin, especially after Dr. Edward J. Schantz and his colleagues purified botulinum toxin type A into crystalline form. In 1953 , Dr. Vernon Brooks, a physiologist, found that injecting tiny amounts of the now scientifically "famous" toxin into a hyperactive muscle blocks the release of acetylcholine from motor nerve endings. This caused temporary "relaxation". In the 60s, ophthalmologist Dr. Alan B. Scott began injecting BTTA (botulinum toxin type A) into monkeys, with a theory that its muscle relaxing effects could help treat crossed eyes (strabismus). Soon after, BTTA became the go-to toxin in researching labs worldwide.
1970-80s
In 1978, Scott gained approval from the FDA to inject human volunteers with tiny amounts of BTTA for experimentation. More research showed that the drug's benefits reached far beyond ophthalmology. It gave temporary relief from facial, neck, vocal cord, and shoulder spasms as well. In 1988, the drugmaker Allergan bought the rights to sell Dr. Scott's batch of BTTA, and in the following year, the FDA approved BTTA for the treatment of eyelid spasms and strabismus. Shortly after the approval, Allergan bought Scott's company and changed the name of the drug to what we know it as today: Botox.
1990s
As research continued, other uses for BTTA were discovered. Scientists found that bladder spasms, cerebral palsy in kids, excessive sweating, and writers cramp could all be temporarily alleviated by injecting miniscule amounts of this neurotoxin. The discovery that most impacted what we think of when Botox comes up was made when Dr. Jean Carruthers realized that her blepharospasm patients were losing their wrinkles in their face. In 1992, both her and her husband published a paper which stated that, "treatment with C. botulinum-A exotoxin is a simple safe procedure" for the treatment of brow wrinkles. Dermatologists instantly took advantage of this "off label" use. By 1997, the demand for Botox spiked so dramatically that the U.S.'s supply ran out, causing panic among those who used it and the NY Times's headline to read "Drought Over, Botox Is Back" once a new batch of BTTA recieved approval from the FDA.
2000s
In 2000, Botox recieved the FDA's go-ahead for the treatment of cervical dystonia. In 2002, Botox Cosmetic (the brand of Botox that fixes wrinkles and lines) got its first government approval, which allowed Allergan to start a multi-million-dollar marketing campaign to raise the already prosperous Botox sales, which had reached $310 million at the end of 2001. Only one year later, Botox had been featured in almost 14,000 TV and stories in hte U.S. alone. At the end of the same year, sales had reached nearly $440 million, and Allergan declared Botox Cosmetic one of the most successful pharmaceutical brand launches in the company's 53 year history. In 2004, Allergan recieved an FDA approval for the use of BTTA to stop excessive underarm sweating. Botox started showing up everywhere. It even became an acceptable gift to friends and family, especially new moms! Doctors pay $400 for one vial of Botox Cosmetic. For each injection, the patient must pay $200. To noone's surprise, the intense popularity and large price tag inspired alot of knockoffs and "bargain basement" treatments by scam artists. By December 2006, Botox sales had gone through the roof with $1 billion in sales. Cosmetic uses accounted for about half of the income. Botox is the #1 non-surgical cosmetic treatment in the U.S.. As this method for removing wrinkles becomes more popular, there are more signs of possible outrages. The Botox Cosmetic has been shown as a method of torture in the TV show Nip/Tuck and the weapon of choice for a murder in the TV show Law and Order. It has been the subject of at least one addiction study, and misuse has brought new meaning to the expression "poker face". People are also more concerned about the credibility of who is performing the injection.
Journal Article
Unfortunately, during my research I did not come upon a single journal article.
References
Mapes, D. (Producer). (2007). Frozen in time: botox over the years. [Web]. Retrieved from http://www.msnbc.msn.com/id/21369061/ns/health-skin_and_beauty
Pearce, J. (2005, May 04). Edward j. schantz. Retrieved from www.nytimes.com/2005/05/04/national/04schantz.html
Pearce, J. (2005, May 04). Edward j. schantz. Retrieved from www.nytimes.com/2005/05/04/national/04schantz.html
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