Cover Botulinum toxin can help reduce excessive sweating of the palms and underarms (Photo: Getty Images)
Botulinum toxin can help reduce excessive sweating of the palms and underarms (Photo: Getty Images)
1 / 1
From treating rosacea to reducing excessive sweating, Dr Lisa Chan reveals novel uses of botulinum toxin many may not know about
Often, what is most confusing and intimidating about clinical beauty treatments is simply our lack of understanding of the fancy medical terms. Not only is it much more approachable once you get to know the basics behind a treatment, you will also sometimes discover there are far more uses for it than you might have imagined.
Botulinum toxin is a good example of this. Consumers tend to know the term, but they might have also heard of its potential risks, which sometimes drive them away from finding out more—let alone giving it a try.
Part of the reason botulinum toxin gets a bad reputation is because when it’s used by unskilled hands, there are higher risks of swelling, pain or bruising, facial crookedness, drooping, or infection. There are also risks associated with food poisoning in an uncontrolled setting, because botulinum toxin is produced by clostridium botulinum, a bacteria that can cause botulism—a rare but fatal form of food poisoning, which Chan acknowledges and doesn’t take lightly.
Read more: The biggest skincare mistakes many of us are making and how to take care of our skin properly
According to Dr Lisa Chan, a general practitioner with a keen interest in medical beauty who is based in Hong Kong, “although botulinum toxin can cause serious botulinum if it’s administered in uncontrolled and excessively high doses, it can also be used safely for medical and cosmetic purposes in small and purified doses," she says. “Indeed, the vial containing botulinum toxin is deliberately prepared such that, even if the entire contents were to be injected, it would remain safe. Botulinum toxin has a proven track record of over three decades of use and continues to be subject to stringent checks and regulations. It would require an extraordinarily large dosage, one that exceeds legal limits, to inflict serious harm.”
Chan goes on to explain that botulinum toxin, “when injected into muscles, it blocks nerve signals that cause muscle contractions, reducing the appearance of wrinkles and treating conditions such as muscle spasms, migraines and excessive sweating”. It also has a long history, full of trial and error, and research in various fields on potential new applications of the neurotoxin is ongoing, and shows promise.
“Over 200 years ago, a German physician named Justinus Kerner identified the potential clinical applications of a toxin extracted from bad sausages,” Chan tells Tatler. “The toxin was named botulinum, deriving from the Latin word ‘botulus’, which means ‘sausage’.”
Chan explains that in 1928, Dr Herman Sommer from the US, isolated the purified form of botulinum toxin type A—one of the only two types used for cosmetic purposes today, which was used during the 1930s as a biological weapon. Despite the insidious role it played in this dark chapter of human history, this research did pave the way for future applications.
The use of botulinum toxin for cosmetic purposes was completely accidental though, Chan says. In 1978, “ophthalmologist Alan B. Scott began FDA trials for the use of botulinum toxin to treat crossed eyes,” and in 1989 it received FDA approval for ophthalmologic treatments. It was during one such treatment that a patient told her eye doctor, Jean Carruthers, that the injection also made the fine lines around her eyes disappear. Carruthers shared this information with her husband, a dermatologist, and together they began experimenting with how the toxin can relax wrinkles, and published a study on the subject in 1992.
Don’t miss: Common struggles faced by new mothers and treatments that can ease postpartum problems
“The FDA approved its use for cosmetic purposes in 2002, specifically for the treatment of frown lines,” Chan says. “Since then, [botulinum toxin] has become one of the most popular non-surgical cosmetic treatments worldwide.”
Since then, Chan says its usage has expanded to include minimising wrinkles on the neck and hand and it has also “been found to be effective in treating medical conditions such as chronic migraines, an overactive bladder, reducing the amount of perspiration,” and more.
However, as research and experiments continue, experts are now finding ways to use botulinum toxin that are more novel and much more geared toward treating a person’s overall wellbeing, even if the concerns it addresses remain physical. For example, preventing scars and managing rosacea, two skin conditions that are typically difficult to treat and can cause its bearer to feel anxiety or lack of self-esteem or confidence when the conditions are on display.
“Botulinum toxin can be used to reduce tension exerted on a wound or surgical incision by the underlying muscles, thereby allowing for better healing with less scar formation,” Chan explains. Whereas for rosacea, the toxin interferes with the nerves of the cutaneous vasodilatory system, which carries heat from the body’s core to the surface of the skin. “However, further research involving large-scale studies with comparative designs and long-term follow-up is needed to determine the value and efficacies in the scar management and rosacea protocols.”
There are even studies on the use of botulinum toxin to treat depression and oily skin. However, Chan stresses that these are still based upon preliminary studies.
“Further studies are still needed to fully understand their efficacy and potential risks. It is important for patients to discuss any concerns and questions with their healthcare provider before undergoing any treatment,” she says.
In case you missed it: Are skincare and beauty lines backed by doctors better than celebrity brands?
Chan also emphasises there are circumstances and conditions under which botulinum toxin should be used with utmost care or not used at all. She says these include those with body dysmorphic disorder, neuromuscular disorders or allergies to the toxin. Those who are pregnant or breastfeeding and who depend on facial expressions for their livelihoods should also steer clear.
Having said all that, Chan is keen to dispel certain myths surrounding botulinum toxin injections, such as that it’s always painful. “In fact, a very tiny needle is used for botulinum toxin injection, and the pain is bearable for most people,” she says. As long as the right dosage is used and the treatment is practised by someone trustworthy with experience, the possibiliies for botulinum toxin are endless.
“As research continues, it is likely that new applications of this versatile neurotoxin will continue to emerge,” Chan says.
This is part of a monthly column in collaboration with Dr Lisa Chan, a Hong Kong-based general practitioner who has an avid interest in medical beauty. Dr Chan, MBChB (CUHK), MScPD (Cardiff), PgDipPD (Cardiff), PGDipClinDerm (Lond), DipMed (CUHK), DCH (Sydney), also holds a master's degree in practical dermatology with distinction at Cardiff University.
