Botox Approved for the Treatment of Chronic Migraines

July 28, 2011 under Botox

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.

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Xeomin Vs. Botox

July 27, 2011 under Botox

July 21, 2011 — The US Food and Drug Administration (FDA) has approved incobotulinumtoxinA (Xeomin, Merz Aesthetics) for a temporary improvement in the appearance of moderate to severe glabellar (frown) lines, the manufacturer announced today.

The approval of incobotulinumtoxinA is based on the results of 2 multicenter US clinical trials involving 547 healthy adults. In both studies, incobotulinumtoxinA significantly improved the appearance of glabellar lines 30 days after the first injection when compared with placebo, the company said.

Headache was the most common adverse reaction seen in the studies (incidence, ≥2% of patients and greater than placebo).

“Xeomin is a promising new option for both patients and physicians and we are encouraged by the response rates seen in the phase III clinical trials,” said Derek H. Jones, MD, an investigator for the US studies, clinical associate professor of medicine at the University of California–Los Angeles, and director of Skin Care and Laser Physicians in Beverly Hills, California, in a company press release.

IncobotulinumtoxinA is already approved for a temporary improvement in the appearance of glabellar lines in 14 countries in the European Union, including Germany, the United Kingdom, France, Italy, and Spain, under the brand name Bocouture.

It was approved by the FDA in July 2010 for the treatment of cervical dystonia and blepharospasm.

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FAQ Botox

July 26, 2011 under Botox, Plastic Surgery FAQ

How long does Botox Last?

Botox lasts between 3-6 months.

Where can Botox be used?

Botox can be used to relax the muscles of the forehead, between the eyebrows, around the eyes (crows feet) and in the armpits to control excessive sweating.

Will I still be able to show facial expression?

A good practitioner who understands the muscles of the face will be able to erase superficial lines, frowns and creases without removing expression.

Are there any long-term problems associated with Botox use?

Botox has been used medically for many years, and, in the hands of a good practitioner, is a very safe product.

Is it painful having Botox injected?

No, not painful, particularly if you cool the area first with icepacks. The needles used are very fine and short.

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