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  • Tracy Spring

How Botox Came to Be

In the 1820s, Dr. Justinus Kerner was tasked with finding a cause of death for several dozen

Germans. It turned out that all the victims had eaten from a batch of improperly prepared

sausages. Dr. Kerner ran experiments that eventually led to a better understanding of the

neurological symptoms of Botulism. His work laid the foundation for how botulinum toxin is

used therapeutically today.

During World War II, the U.S. wanted to use botulinum toxin as a chemical weapon. One

supposed plan was to have Chinese prostitutes slip it into the food or drink of high-ranking

Japanese officers.

After the war, researchers looked to find a positive use for the toxin. Dr. Edward J. Schantz and

his partners purified botulinum toxin type A into crystalline form. Then in 1953, physiologist Dr.

Vernon Brooks noticed that injecting tiny amounts into hyperactive muscles blocked the release

of acetylcholine from nerve endings, causing temporary relaxation.

In the 1960s, Ophthalmologist Alan Scott started injecting botulinum toxin type A into the eyes

of monkeys, hoping it could help with strabismus (crossed-eyes).

In 1978 Dr. Scott was granted permission to begin injecting botulinum toxin into human eye

muscles to correct strabismus. He reported that the effect of the botulinum toxin stayed localized to the target muscle, lasted for a good amount of time, and had no real side effects. In

1989 what we now know as "Botox" was FDA approved to correct strabismus and

blepharospasm (eyelid spasm) thanks to Scott. (At that time the drug was called Oculinum, but

when Scott sold the rights to Allergan the name was changed to: “Botox.”)

Botox really took off in the 1990s. Canadian ophthalmologist Dr. Jean Carruthers noticed her

blepharospasm patients were starting to lose their frown lines. She and her dermatologist

husband published a study in the Journal of Dermatologic Surgery and Oncology in 1992. They

stated that (temporarily) treating brow wrinkles could be done simply and safely using

botulinum toxin. Dermatologists everywhere began to take advantage of this off-label use.

Botox became so popular, so quickly, that by 1997 the country’s supply temporarily ran out!

It wasn’t until 2002 that the FDA approved Botox for cosmetic use, specifically glabellar lines

('frown lines" between the eyebrows). It has since been approved to treat canthal lines

(“crow’s feet”) as well as horizontal forehead lines. Botox has also been approved to treat neck

and shoulder spasms (dystonia), excessive sweating (hyperhidrosis), migraine headaches,

overactive bladder, and more. It’s also used off-label to treat several medical issues. The drug is

a godsend for many in need of relief from pain or discomfort.

Botox is among the most widely researched medicines in the world, and the potential

applications for it are numerous. A recent study even showed that it could help manage

depression by interrupting feedback between facial muscles and the brain.

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