15 years ago, a new
beauty trend was born when some researchers realized that wrinkles could be immediately eliminated with crap botulinum toxin injections.
5 years ago the little bee sting received its official government OK. Botox however, goes back a much much longer time and has a surprising history.
Dr. Justinus Kerner began to study a batch of improperly prepared blood sausages responsible for the death of several dozen Germans. Kerner posited that there was something in the spoiled sausages that brought on the disease, something he called â€œwurstgiftâ€ (German for sausage poison).
Kerner must have been a masochist, as he injected himself with some of the toxic stuff and his experiments and case studies led to a better understanding of the neurological symptoms of food-borne botulism (drooping eyelids, difficulty swallowing, muscle weakness, and if left untreated, paralysis and respiratory failure). He also offered up suggestions for treatment and prevention of food poisoning, and paved the way for todayâ€™s therapeutic use of the toxin.
Dr. Emile Pierre van Ermengem of Belgium was asked to investigate an outbreak of botulism following a funeral dinner where three people died and 23 were paralyzed. (Apparently, somebody brought a bad ham.)
Van Ermengem, who had studied under Dr. Robert Koch was able to make a connection between botulism and a spore-forming bacterium he named Bacillus botulinus. A raft of studies followed and seven strains of botulinum toxin were eventually identified (A through G); four of them (A, B, E and F) would be shown to cause illness in humans.
With the outbreak of World War II, the U.S. began researching biological weapons, including botulinum toxin (the nerve toxin produced by Clostridium botulinum), considered to be deadliest substance in the world. One plan, according to a 2004 article in Clinical Medicine (The Journal of the Royal College of Physicians of London), was to have Chinese prostitutes slip tiny toxic pills into the food and/or drink of high-ranking Japanese officers. According to the authors, a batch of gelatin capsules filled with botulinum toxin was produced, but the project was abandoned before the poison pills could be put into action.
’50s and â€™60s
With the war over, researchers began focusing on the more beneficial aspects of this powerful toxin, particularly after Dr. Edward J. Schantz and his colleagues were able to purify botulinum toxin type A into crystalline form. In 1953, physiologist Dr. Vernon Brooks discovered that injecting small amounts into a hyperactive muscle blocked the release of acetylcholine from motor nerve endings, causing temporary â€œrelaxation.â€ In the 1960s, ophthalmologist Dr. Alan B. Scott started injecting botulinum toxin type A into monkeys, theorizing its muscle-relaxing effects might help in the treatment of crossed eyes (or strabismus). Before long, botulinum toxin type A became the go-to toxin in research labs around the world (despite fears about its use in â€œgerm warfareâ€).
’70s and â€™80s
In 1978, Scott received FDA approval to inject tiny amounts of botulinum toxin into human volunteers and soon, the results started rolling in. In the early 1980s, the eye doctor published a number of studies including a 1981 paper in the Transactions of the American Ophthalmological Society that asserted botulinum toxin â€œappears to be a safe and useful therapy for strabismus.â€ Additional research showed the drugâ€™s benefits went beyond ophthalmology, providing patients with temporary relief from facial spasms, neck and shoulder spasms, even vocal cord spasms. In 1988, drugmaker Allergan acquired the rights to distribute Scottâ€™s batch of botulinum toxin type A (or Oculinum, as it was then known) and a year later, the FDA approved botulinum toxin type A for the treatment of both strabismus and blepharospasm (spasms of the eyelid muscle). Shortly thereafter, Allergan acquired Scottâ€™s company and changed the drugâ€™s name to the compact, catchy â€œBotox.â€
As research continued, other potential uses came to light. Bladder spasms, writer’s cramp, excessive sweating, even cerebral palsy in kids all were alleviated â€” at least for a short time â€” by injections of the neurotoxin. But by far the most earth-shattering discovery came about by accident when Canadian ophthalmologist Dr. Jean Carruthers noticed her blepharospasm patients were starting to lose their frown lines. In 1992, she and her dermatologist husband published a study in the Journal of Dermatologic Surgery and Oncology stating that though temporary, â€œtreatment with C. botulinum-A exotoxin is a simple, safe procedureâ€ for the treatment of brow wrinkles. Dermatologists from Hollywood to Hoboken immediately took note (and took advantage of this â€œoff-labelâ€ use) and by 1997, Botox use spiked so high the countryâ€™s supply temporary ran out, causing panic among its devotees and prompting the New York Times to announce â€œDrought Over, Botox Is Backâ€ once a new batch received FDA approval.
2000 and beyond
With the new millennium, FDA approvals continued to roll in. In 2000, Botox got the FDAâ€™s nod for the treatment of cervical dystonia (neck and shoulder spasms); in 2002, Botox Cosmetic (the frown-line fixer) got its official government go-ahead, greenlighting Allergan to begin a multi-million-dollar marketing campaign to boost its already healthy Botox sales, which had reached $310 million by the end of 2001.
Fast forward a year and the drug had been profiled in nearly 14,000 TV and print stories (in the U.S. alone), end-of-year sales had reached nearly $440 million and Allergan had proclaimed Botox Cosmetic one of the most successful pharmaceutical brand launches in the companyâ€™s 53-year-history. In 2004, Allergan received yet another FDA approval, this time for the treatment of severe underarm sweating (hyperhidrosis), but for most people, the therapeutic uses of this nimble neurotoxin were just icing on a pretty, well-preserved cake.