Experience May Be Dispelling the 'Old Wives' Tales of Botox

SANTA MONICA, CALIF. — In the early days of cosmetic botulinum toxin type A therapy, rumors greatly outnumbered scientific facts about its safety, storage, and storied effect on furrowed brows and deep crow's feet.

The faculty at a recent cosmetic dermatology seminar sponsored by Skin Disease Education Foundation helped to put some of these myths to rest.

▸ Botox is deadly. Among 28 deaths reported to the Food and Drug Administration from December 1989 to May 2003, none involved cosmetic use of Botox (J. Am. Acad. Dermatol. 2005;53:407–15). Indeed, of 16 deaths recently highlighted by citizens' groups, all involved serious disorders treated with huge volumes of Botox, said Dr. Allan Wirtzer, a dermatologist in private practice in Sherman Oaks, Calif.

Among the potentially deadly uses of Botox is treatment of severe cervical dystonia, which can lead to spread of the toxin to the esophagus, prompting dysphagia or aspiration pneumonia.

▸ Book prewedding Botox sessions on Friday afternoons. Disappointed brides and furious mothers-in-law will blame you for the wedding pictures if you schedule cosmetic procedures too close to the ceremony, said Dr. Mitchell Goldman, a dermatologist in private practice in La Jolla, Calif. Botox's full effect takes 5–6 days, and unexpected bruising may need time to heal.

▸ Avoid freezing. The refrigerator is the place for Botox, but Dr. Richard Glogau, a dermatologist in San Francisco, may have chipped away at the myth that freezing "will degrade the molecule," when Botox that was frozen by mistake worked just fine on his patients, Dr. Goldman said.

▸ Save the paralysis for the muscles. There was a day when patients were told to sit perfectly upright, avoid exercise, and cancel air travel plans for hours after Botox injections. These precautions are "just old wives' tales—such ridiculous stuff," said Dr. Goldman.

Dr. Wirtzer has served as a consultant for Medicis, distributor of Reloxin (botulinum toxin type A, not approved in the United States). Dr. Goldman has received grant support from, and served as a consultant and speaker for, Allergan Inc., maker of Botox.

SDEF and this news organization are wholly owned subsidiaries of Elsevier.

SANTA MONICA, CALIF. — In the early days of cosmetic botulinum toxin type A therapy, rumors greatly outnumbered scientific facts about its safety, storage, and storied effect on furrowed brows and deep crow's feet.

The faculty at a recent cosmetic dermatology seminar sponsored by Skin Disease Education Foundation helped to put some of these myths to rest.

▸ Botox is deadly. Among 28 deaths reported to the Food and Drug Administration from December 1989 to May 2003, none involved cosmetic use of Botox (J. Am. Acad. Dermatol. 2005;53:407–15). Indeed, of 16 deaths recently highlighted by citizens' groups, all involved serious disorders treated with huge volumes of Botox, said Dr. Allan Wirtzer, a dermatologist in private practice in Sherman Oaks, Calif.

Among the potentially deadly uses of Botox is treatment of severe cervical dystonia, which can lead to spread of the toxin to the esophagus, prompting dysphagia or aspiration pneumonia.

▸ Book prewedding Botox sessions on Friday afternoons. Disappointed brides and furious mothers-in-law will blame you for the wedding pictures if you schedule cosmetic procedures too close to the ceremony, said Dr. Mitchell Goldman, a dermatologist in private practice in La Jolla, Calif. Botox's full effect takes 5–6 days, and unexpected bruising may need time to heal.

▸ Avoid freezing. The refrigerator is the place for Botox, but Dr. Richard Glogau, a dermatologist in San Francisco, may have chipped away at the myth that freezing "will degrade the molecule," when Botox that was frozen by mistake worked just fine on his patients, Dr. Goldman said.

▸ Save the paralysis for the muscles. There was a day when patients were told to sit perfectly upright, avoid exercise, and cancel air travel plans for hours after Botox injections. These precautions are "just old wives' tales—such ridiculous stuff," said Dr. Goldman.

Dr. Wirtzer has served as a consultant for Medicis, distributor of Reloxin (botulinum toxin type A, not approved in the United States). Dr. Goldman has received grant support from, and served as a consultant and speaker for, Allergan Inc., maker of Botox.

SDEF and this news organization are wholly owned subsidiaries of Elsevier.

SANTA MONICA, CALIF. — In the early days of cosmetic botulinum toxin type A therapy, rumors greatly outnumbered scientific facts about its safety, storage, and storied effect on furrowed brows and deep crow's feet.

The faculty at a recent cosmetic dermatology seminar sponsored by Skin Disease Education Foundation helped to put some of these myths to rest.

▸ Botox is deadly. Among 28 deaths reported to the Food and Drug Administration from December 1989 to May 2003, none involved cosmetic use of Botox (J. Am. Acad. Dermatol. 2005;53:407–15). Indeed, of 16 deaths recently highlighted by citizens' groups, all involved serious disorders treated with huge volumes of Botox, said Dr. Allan Wirtzer, a dermatologist in private practice in Sherman Oaks, Calif.

Among the potentially deadly uses of Botox is treatment of severe cervical dystonia, which can lead to spread of the toxin to the esophagus, prompting dysphagia or aspiration pneumonia.

▸ Book prewedding Botox sessions on Friday afternoons. Disappointed brides and furious mothers-in-law will blame you for the wedding pictures if you schedule cosmetic procedures too close to the ceremony, said Dr. Mitchell Goldman, a dermatologist in private practice in La Jolla, Calif. Botox's full effect takes 5–6 days, and unexpected bruising may need time to heal.

▸ Avoid freezing. The refrigerator is the place for Botox, but Dr. Richard Glogau, a dermatologist in San Francisco, may have chipped away at the myth that freezing "will degrade the molecule," when Botox that was frozen by mistake worked just fine on his patients, Dr. Goldman said.

▸ Save the paralysis for the muscles. There was a day when patients were told to sit perfectly upright, avoid exercise, and cancel air travel plans for hours after Botox injections. These precautions are "just old wives' tales—such ridiculous stuff," said Dr. Goldman.

Dr. Wirtzer has served as a consultant for Medicis, distributor of Reloxin (botulinum toxin type A, not approved in the United States). Dr. Goldman has received grant support from, and served as a consultant and speaker for, Allergan Inc., maker of Botox.

SDEF and this news organization are wholly owned subsidiaries of Elsevier.