Besides being effective in treating rhytides, Botox and other botulinum neurotoxin (BoNT) are also efficacious for seven non-cosmetic indications, according to a review in the August issue of Plastic and Reconstructive Surgery.
Migraines, upper limb spasticity, neuropathic pain, facial dystonias, facial nerve palsy and aberrant regeneration, hand tremor and palmer hyperhidrosis all benefited from BoNT, with high-quality evidence to support good responses.
“Neuropathic pain and hand tremor are two less known uses for BoNT and may be a surprise to some clinicians,” lead author Marie E. Noland, M.D., senior plastic surgery resident physician at Dalhousie University in Halifax, Nova Scotia, Canada, tells Cosmetic Surgery Times.
Dr. Noland says that BoNT’s versatility is effective at multiple sites in the body, “including but not limited to the neuromuscular junction, the ubiquitous relay center between all nerves and muscles, making almost any location in the body a possibility for targeted therapy.”
Additionally, with the drug being delivered in such small volumes, “precise and focused injections are possible with relative ease of use and limited spread to unwanted areas,” Dr. Noland notes. “Its dose-dependent nature allows preservation of muscle function while targeting unwanted conditions.”
BoNT’s high-safety profile and impermanence also “makes it possible to experiment in different clinical settings,” Dr. Noland says.
The international review identified rhytides and the seven non-cosmetic indications treated by plastic surgeons. And although the evidence is strongest for the minimally invasive treatment of rhytides, botulinum neurotoxin is also effective for dystonias, such as tics caused by benign essential blepharospasm.
Two studies have also concluded that Botox can reduce hand tremors in patients with essential tremor, although hand function may not improve. BoNT also shows promise for treatment of muscle spasticity in children with cerebral palsy.
In addition, based on three large studies, Botox has been approved for treatment of chronic migraine headaches.
Neuropathic pain, for which there are few effective treatments, can also be remedied with BoNT, including pain caused by diabetes and surgical nerve damage.