If you’ve ever used Botox, you probably didn’t shout it from the rooftops. But it might soon lose that stigma. The popular non-surgical cosmetic treatment that temporarily reduces the appearance of wrinkles is increasingly being used to treat conditions like migraines, asthma and more.
“It’s almost becoming like aspirin—people are trying it for all kinds of things,” says Dr. Brian Bonanni, medical director of Gotham LASIK & Skincare in Manhattan.
One reason is that Botox, the brand name of a neurotoxin that works by paralyzing or weakening muscles and nerves, is extremely safe when administered by a trained physician and only rarely has side effects. (If you’ve heard any horror stories about complications, it’s likely the result of someone receiving the injection from an untrained provider. Beware “Botox parties.”)
In addition, Botox is appealing for its temporary effect. “Using Botox long-term doesn’t seem to be a problem as far as we know,” says Dr. Hratch Karamanoukian, director of the Center for Excessive Sweating in Williamsville, N.Y. “That’s because the body eventually will metabolize the drug.” If the treatment doesn’t work, a patient can discontinue its use without any consequences.
For any use, cosmetic or therapeutic, Botox typically has to be administered every 3 to 6 months—not a quick one-time fix, but for many patients less maintenance than taking a daily pill.
Here are some of the chronic conditions, from frustrating to debilitating, for which Botox is helping offer relief, both off-label and with government approval.
Of the nearly 30 million Americans who suffer from chronic migraines, many have been prescribed everything from heavy-duty painkillers to anti-seizure medications to prevent or ease the debilitating pain. But an increasing number are receiving relief from Botox, which the U.S. Food and Drug Administration approved to treat the condition in 2010.
“It was originally noticed by people who were using Botox for cosmetic brow lifts,” says Dr. Jeffrey Spiegel, chief of the division of facial plastic and reconstructive surgery at Boston University Medical Center. “Patients were reporting a significant decrease in chronic headaches.”
Experts aren’t yet sure exactly how the drug prevents migraines, though they theorize that it may relax the muscles in the head and neck area, prevent spasms and/or relieve pressure on the nerves in the area. The injections are administered to several trigger points in the face and head, depending on where the individual most often experiences pain.
Botox is recommended for patients who have 15 or more migraine days a month, but if you have fewer and they’re extremely debilitating, your doctor can use his or her discretion.
It may not be a physically painful condition, but hyperhidrosis, or abnormal sweating, is hardly a cosmetic concern—it can interfere with a person’s social activities, career and general quality of life. For some of these sufferers, Botox has been a game-changer.
“I see patients from all walks of life, but they feel they are isolated, like no one else has this problem,” says Karamanoukian.
For hyperhidrosis, Botox is injected not into muscle, but into skin, where it appears to stop overactive nerves from sending signals to the sweat glands. It can be injected anywhere the sweating is occurring, from palms to scalp to groin, but tends to have the best results in small areas like the underarms.
The most recently approved therapeutic use of Botox is for urinary incontinence — but it’s not just for any overactive bladder. The specific condition, called “neurogenic bladder” is found in patients with spinal cord injury or multiple sclerosis. “What happens with these patients is, as the bladder is filling up, instead of it relaxing to take more urine, it starts contracting, and by contracting, they urinate,” Karamanoukian says.
Botox treatment for incontinence is more invasive than other uses. It requires the use of a scope inserted in the urethra to inject the drug directly into the bladder, a procedure that usually is accompanied by general anesthesia. The good news? The effects last nine months, far longer than other applications. Clinical trials are currently underway to see if Botox may be helpful for patients with other types of incontinence unrelated to neurological conditions.
This summer, a group of Australian researchers announced plans to test the use of Botox for the treatment of asthma.
“Asthma symptoms are really due to the constriction of the airway,” Bonanni says. “The muscles in the larynx are spasming and closing off the breathing area. Botox could relax those muscles.”
That’s just one of the more than 100 conditions that Botox has been tested for, according to the company that manufactures the drug, and the possibilities seem endless. “On the horizon, there may even be a role for it in helping with runny noses,” says Spiegel. “We expect in the near future for the therapeutic uses to outweigh the cosmetic.”