Jennifer Walden, MD, Plastic Surgery and Aesthetic Medicine
Oct 20, 2010
The United States FDA last week approved Botox, the anti-wrinkle shot from Allergan, as a treatment to prevent chronic migraines. This came after the company agreed last month to pay $600 million to settle allegations that it had marketed the drug for off-label uses for years.
The FDA’s decision endorses doctors’ use of Botox to treat patients who suffer from a severe form of migraine involving headaches at least 15 days a month. Botox is already approved by the FDA to treat blepharospasm, strabismus, hyperhydrosis, cervical dystonia, and muscle spasticity in the upper extremities. It is widely known as the most popular wrinkle smoother on the planet and is approved for cosmetic purposes to treat glabellar furrows between the eyebrows. Interestingly, Allergan projects that sales of Botox for chronic migraine and other medical uses would soon exceed sales of the drug as a wrinkle smoother… but I’m not so sure of that. Often insurance companies do not pay for medical uses (including treatment of migraines), and the out of pocket expenses can be quite high. Cosmetic patients expect such treatments to be an out of pocket expense and can typically afford it.

