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Botox: 'Wonder drug of this century'


New York - Jean D. Carruthers, M.D., thinks it might be appropriate for her and her dermatologist husband, Alastair, to change their middle names to "determination."

The "d" word as she terms it, is what it has taken to not only get botulinum toxin type A (Botox®, Allergan) accepted by the medical community, but making it is one of the most frequently performed cosmetic procedures in the U.S.

And the Carruthers now have a 15-year retrospective study to prove the drug's safety - an aspect often cited as a patient concern. The study coincides with Botox's 15th anniversary. The husband and wife team couldn't be happier that a drug they have believed in for many years and has been in existence as a compound since 1979, now has the safety data to back up its cosmetic use.

Alastair Carruthers is affiliated with the department of dermatology, University of British Columbia, Vancouver; Jean with the department of ophthalmology, University of British Columbia, Vancouver. They have a private practice, the Carruthers Dermatology Centre, Inc., in Vancouver.

The study The study, Long-Term Safety Review of Subjects Treated with Botulinum Toxin Type A for Cosmetic Use, (see related story, page 94), was presented at the recently concluded American Academy of Dermatology Academy '04 meeting.

The study shows treatment with Botox for facial aesthetic procedures is safe and well tolerated when used for multiple treatment sessions over an extended period of time and when administered by a qualified and trained healthcare professional.

According to Alastair, looking back, the current study's positive results have been long-awaited.

"Getting accepted has been frustrating for so long," he tells Dermatology Times. "We could see the potential, we knew it was a winner, but no one was listening to us."

"They were frightened," continues Jean. "There was an article published in 1969 that called botulinum type A 'the most poisonous poison.' That stuck in the consciousness of a lot of people. It had to overcome that reputation.

The Carruthers describe experiencing the success of Botox as "absolutely amazing." A belief in themselves, the product and a healthy dose of tenancity fueled them.

"It was such a fringe idea in 1987; we never would've believed it would enjoy the success it's having today," says Jean. "It was quite difficult to get 30 participants to put our first study together. People would say, 'You want to inject what in my face?' We got used to disbelief. We got used to people saying, 'no thanks,' yet when you injected them and saw the results, it was so rewarding. We knew it was just a matter of keeping at it."

Still overcoming obstacles Even though Botox has overcome many of the obstacles that it first confronted, the education battle is still not over.

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