Neurotoxins, particularly Botulinum toxin, have become a popular anti-aging treatment worldwide. Interestingly, their journey from a deadly toxin to a cosmetic marvel involves a fascinating story of discovery by two medical professionals: a dermatologist and an ophthalmologist.
The Discovery
In the 1970s, dermatologist Dr. Jean Carruthers and her husband, ophthalmologist Dr. Alastair Carruthers, observed an intriguing side effect during their clinical work. Patients receiving Botulinum toxin injections for medical conditions like strabismus (crossed eyes) and eyelid spasms reported a reduction in facial wrinkles, especially around the eyes and forehead.
Their curiosity led them to investigate further. In 1989, they published their findings demonstrating that Botox (a brand of Botulinum toxin) could temporarily relax targeted muscles, smoothing out wrinkles. This discovery transformed the toxin into a cosmetic treatment, opening a new avenue in dermatology and aesthetic medicine, completely changing how we look as we age.
Timeline of Development and Commercial Success
- 1978-1989: Drs. Carruthers begin observing and documenting wrinkle improvements in patients treated for eye muscle disorders.
- 1992: The FDA approves Botox for medical uses such as strabismus and eyelid spasms.
- 2002: The FDA approves Botox for cosmetic use to treat frown lines.
- 2000s: Botox becomes a billion-dollar industry. Pfizer, the company that acquired rights to Botox in the late 1990s, reported significant earnings from its sales. By 2023, Pfizer’s revenue from Botox was estimated to exceed $4 billion annually.
The Ethical Dilemma
It’s noteworthy that the pioneering doctors—Drs. Carruthers—did not profit financially from the cosmetic use of Botox. The rights to commercialize Botox were held by pharmaceutical companies like Allergan (later acquired by AbbVie). Many physicians and researchers who contributed to its cosmetic application did not receive direct financial benefits; instead, profits were generated by the pharmaceutical firms.
This raises interesting questions about fairness and the ethics of medical innovation: should the clinicians who discover new uses for existing treatments share in the profits? While the doctors did not gain financially, their discovery revolutionized aesthetic medicine and improved countless lives.