Last week’s headlines about the possible dangers of Botox were scary:
- “Is Botox Botoxic?” (a blog post that asks its readers, “Would you get Botox, even if it means risking your life?”)
- “Botox ‘killed four children’ “ (not the type of Botox that people think of)
- “Calls for Botox warnings after 16 people die from cosmetic jab.” (Wrong!!)
My article in the O.C. Register and on the Register Web site does a better job than most — perhaps a better job than all others — at setting the record straight. “Blues for Botox? Cosmetic version of botulinum toxin has least serious health effects,” is our headline.
It makes clear that the health problems reported in connection with injections of Botox and a similar treatment are primarily related to the more potent therapeutic uses of the drug, which can relieve muscle spasms, among many other ailments. Botox for cosmetic use is implicated in at most one 47-year-old woman’s death during its multi-year history. More likely no deaths. Botox-maker Allergan of Irvine makes a strong case that her death wasn’t caused by Botox, but occurred coincidentally seven weeks after a cosmetic Botox injection.
In addition to the comments that I included in the article, here are other remarks on the topic from doctors near and far:
It is irresponsible for Public Citizen to claim that appropriate use of botulinum toxin type A (which is FDA approved and has a safety profile better than aspirin) is likely to cause life-threatening problems. I can guarantee that inappropriate use of any medication can cause unwanted (consequences), but the sensational claims concerning Botox are unfounded.
The safety profile of Botox is extraordinary. Remember that this agent was used for therapeutic (non-cosmetic) indications in children for over a decade before the more cosmetic indications were noted. As always, the public (and State Medical Boards) should be mindful of the fact that injection of Botox is a medical procedure and is best performed by appropriately trained physicians.
Q. Will you continue to inject it for patients who request it to remove facial lines? A. Absolutely. I see no downturn in interest in receiving muscle relaxing treatments. Ironically, and based on these recent concerns, patients will be more likely to seek Botox injections from experts in the field such as dermatologists and plastic surgeons.
Q. Did you get new questions from patients on Thursday about the safety of using Botox? A. None whatsoever. A big yawn …”.
– Dr. Christopher Zachary, chairman of the Department of Dermatology, UCI School of Medicine
If people are getting Botox injections at a spa, they should know whether it’s real Botox and who mixed the injection. It comes in crystal form in a vial, so you have to add saline solution. Does the person who’s injecting it know human anatomy and which muscles to target?
– Dr. Vince Afsahi, dermatologist in Tustin and Newport Beach
This is not an assault on the the product per se. We accept that it works, but patients and health-care providers are underinformed about the problems. … (After a Botox injection) patients need to know that, if they’re having difficulty swallowing, they should contact the doctor.
Q. Is Botox safer than aspirin? Botox can lock up the muscles of the esophagus, called dysphagia, while than aspirin can cause gastrointestinal bleeding. A. That’s a comment for the media, not a scientifically supportable statement. How many cases of dysphagia are equivalent to a case of gastrointestinal bleeding?
– Dr. Peter Lurie, department director for Public Citizen’s health research group
I am happy to see there are groups looking out for my health and safety, but I don’t believe the Public Citizen’s group is adding anything new here. If anything, they are creating a stir about what is already well known. Most of the adverse effects they speak of are occurring when botulinum toxin is used to treat disabling disorders therapeutically. Without its use, many of these patients will have a greater degree of suffering. The risk to benefit ratio is not being presented. As they present, scant data is present regarding dysphagia and aspiration when botulinum toxin is used in a cosmetic fashion. I don’t believe ‘reorganizing’ the labeling, while not adding anything that isn’t already presented there, adds much. One should be reading the entire label to begin with.
In my hands, when used for cosmetic purposes, I do not see the adverse effects they speak of. When used for disabling neuromuscular disorders, which require injections around the esophagus, yes, this muscle weakening medication may weaken the esophageal muscles.
– Samir Pancholi, cosmetic surgeon, Las Vegas
