When you hear the word Botox, chances are you think about fine lines, wrinkles and working to defy age. While the FDA approved Botox in 1989, some people don’t know that it has medical uses. This drug now pushes far outside of aesthetic medicine to provide an option for a wide array of medical needs.
Botox has been heralded in helping reduce spasticity in the hands of children who have cerebral palsy. It has also been used to treat patients who struggle with incontinence as a side effect of Parkinson’s disease. The drug can provide relief from chronic migraines, debilitating muscular conditions and rare disorders that make it difficult for food and liquid to pass into the stomach. While some of these conditions are severe, Botox is also used in the treatment of twitching eyes, tension headaches and excessive sweating.
Dr. Stacy Blecher, an internal medicine specialist at the Medical University of South Carolina, said many patients and friends have asked her if Botox is right for them.
“I definitely think there is a role for Botox outside the world of aesthetic medicine, and I think that role is ever-expanding,” she said. “I would stress, however, that Botox is still considered a second line treatment for chronic migraines and also a second line agent in the treatment of excessive sweating.”
In order to receive Botox treatment for chronic migraines, Dr. Blecher said patients must have more than 15 headache days per month.
People struggling with excessive sweating, technically known as hyperhidrosis disorder, must also meet certain criteria to receive Botox treatment. For those wondering if they have hyperhidrosis disorder, Dr. Blecher said this condition is defined by the following criteria: focal, visible, excessive sweating of at least six months duration without apparent cause. Patients must also meet at least two of the following characteristics: bilateral and relatively symmetric sweating; impairs daily activities; at least one episode per week; onset before age 25; family history of idiopathic hyperhidrosis; sweating that stops during sleep.
When asked about the uses of Botox in internal medicine, Dr. Blecher said, “I have seen it used with good success in patients suffering from spasticity (especially of the lower limbs) secondary to cerebral palsy, stroke or other spinal cord injuries. In the subspecialty of gastroenterology, I have seen great success using Botox injections into the lower esophageal sphincter for the treatment of achalasia. This is an especially wonderful option for older patients who may be too frail to safely undergo the standard surgical treatment for the painful condition that makes it nearly impossible to comfortably swallow food.”
Mount Pleasant dermatologists Dr. Marguerite Germain and Dr. Ashton Rountree of Germain Dermatology provided an extensive list of diseases and disorders that can be treated with Botox. While Dr. Germain said she saw an increase of people asking for Botox treatment for hyperhidrosis about five years ago, she thinks that people aren’t aware of this option.
“Botox can be used in treating hyperhidrosis disorder not only under the arms but also the palms of hands, soles of feet, face and even the head and scalp,” said Dr. Germain. “Botox treatment for excessive sweating can last from eight to 12 months.”
Dr. Germain spoke of the success she has seen from treating patients who sweat excessively with Botox. She recalled a wonderful success story concerning the first time she treated a patient with hyperhidrosis disorder.
“Excessive sweating is inherited and can be very embarrassing. The first time I treated a patient with hyperhidrosis, I got a phone call soon after from the patient. I was worried that something went wrong because she asked to interrupt me when I was with other patients. She was a teenager, and she was calling to tell me how grateful she was, that I had changed her life,” Dr. Germain remembered.
Dr. Germain went on to say that her patient was a young lady who had stopped raising her hand in class. She was too embarrassed by the sweating and it was affecting her day-to-day life.
Insurance coverage can be a frustrating issue for those looking for Botox treatment. While many uses are FDA-approved, the patient’s insurer does not necessarily approve them. As a result, patients might need to seek treatment from a specialist. For example, treatment for migraines and paralysis will have a better change of being covered by insurance if patients are seeing a neurologist. By the same token, those hoping for Botox treatment for incontinence should seek treatment from their urologist.
Dr. Germain frequently sees patients who have received Botox treatment from a neurologist for chronic migraines and want her to help remove the visible side effects requiring aesthetic treatment. She also works closely with dentists in treating patients with bruxism, the medical term for teeth grinding or clenching. Often, patients seeking treatment for bruxism have hypertrophy of the masseter muscle as a side effect of the condition, which makes their jaw more square. Botox can be used to stop the grinding and clenching and also to help thin out the jawline.
Dr. Germain also frequently treats patients who suffer from tension headaches. Botox is used to ease tension in a trigger point along the head in the frontalis muscle. “Just relaxing that muscle gives long-term relief. For tension headaches, results from Botox treatment can last anywhere from three to six months, ideal for those new to Botox to determine if this form of treatment works for them,” Dr. Germain said.
Some doctors treat patients who suffer from constant eye twitching with Botox. Dr. Germain tries to stay away from this treatment because eye twitching is typically caused by stress and lack of sleep. Patients can often see positive results from drinking more water, getting adequate rest and changing their diet. Before using Botox, she recommends limiting dairy, soy, gluten and peanuts to see if diet works just as well.
While Botox has a reputation for being a cosmetic drug used for wrinkles, it now provides innovative medical treatment for many patients – so don’t be surprised if your doctor mentions Botox to help you solve problems beyond the realm of aesthetics.
