BOTOX®: The Story Of A Wrinkle-Free Solution


Given the many developments and medical advances related to BOTOX® in recent years, it may seem like its uses—from smoothing wrinkles to preventing migraines—are boundless. But before the treatment became the global phenomenon it is today, it was once seen as a limited therapy mainly focusing on ocular dystonia, the technical term for spasms of the eye muscles.


In 1949, researchers first discovered that botulinum toxin was capable of blocking neuromuscular transmissions. The toxin is a multifaceted protein made from the bacteria “Clostridium botulinum.” Because of its powerful effects, it had to be purified multiple times before it could regularly and reliably be used for any of its numerous benefits. When it comes to BOTOX®, Portland’s dermatologist-led team at The Waldorf Center For Plastic Surgery is happy to explain how it works, where it comes from, and more.


Patients do frequently have questions, because BOTOX® has become the most commonly administered nonsurgical facial cosmetic treatment in North America. Its name recognition alone is often enough to spark curiosity in people who want to know more about this injectable they have heard of, but do not fully understand.


The Discoveries of Clostridium Botulinum and BOTOX®


The origins of BOTOX® date back to almost 200 years ago. Belgian scientist Emile Pierre van Ermengem first identified Clostridium botulinum following a botulism epidemic in Belgium, when numerous people displayed similar symptoms after eating bad sausages. In 1822, Justinus Kerner, a German physician, studied the effects of the bacteria, noting that it inhibited numerous functions throughout the body and could combat hyperhidrosis or excessive sweating.


During the 1920s, scientists at the University of California, San Francisco, first tried to separate the botulinum toxin, but it took approximately 20 years before anyone was ultimately able to isolate it in crystalline form—a task achieved by Dr. Edward Schantz.


In 1985, botulinum toxin began to be used to treat strabismus, a condition that causes the eyes to fail to properly align. This led to the discovery of its ability to also treat such conditions as uncontrolled blinking and lazy eye during the late 1980s. Manufacturer Allergan ultimately licensed the treatment and branded it BOTOX®.


This means BOTOX® has its roots in eye care, as ophthalmologists with an oculoplastic surgery background have treated spastic disorders of the eyelid with botulinum toxin for years, paving the way for more applications in roughly the same area of the body.


Between 1980 and 1990, Dr. Jean Carruthers from Vancouver accidentally discovered a cosmetic use for botulinum toxin while he was using BOTOX® to treat patients with symptoms of blepharospasm (the involuntary tight closure of the eyelids). He observed that these patients were left with virtually no expression lines between their eyebrows, an area also known as the glabella.


From that discovery forward, doctors began to take advantage of the neuromodulator as a solution for wrinkles and facial creases. The FDA eventually began approving BOTOX® for a variety of cosmetic uses (such as frown lines and other common facial lines) in addition to medical applications.


Currently, BOTOX® is approved by the FDA for three cosmetic uses and more than half a dozen medical uses.


The Continuing Popularity of BOTOX®


Why has BOTOX® enjoyed so much success for so long? Part of its popularity is surely due to its versatility. It also requires little to no recovery time, and it's a relatively low-cost solution compared to surgical procedures. The growing popularity of BOTOX® for both women and men and the associated familiarity with its name have somewhat obscured the history of the toxin and its original uses. However, researchers in the medical field haven't forgotten and are continuously pushing the boundaries of new uses for BOTOX®.


To learn more about The Waldorf Center for Plastic Surgery and its BOTOX® treatments, get answers from Dr. Kathleen Waldorf and her team in Portland. Call 520-618-1630 or visit