Botox (botulinum toxin type A) is most commonly known as a cosmetic enhancement, smoothing wrinkled foreheads and erasing crow’s feet.
Lesser known, however, are the myriad of medical uses for Botox by doctors in fields as wide-ranging as neurology, podiatry, and even urology.
Here are 8 conditions Botox injections can help treat:
1. Eyelid spasms (blepharospasms)
The neurotoxin in Botox causes temporary paralysis and thus “blocks how the nerves communicate with the muscles,” explained Dr. Jenny Yu, assistant professor of ophthalmology at the University of Pittsburgh Medical Center.
This is useful for doctors when muscles do something they shouldn’t do, such as spasming.
In fact, when the U.S. Food and Drug Administration (FDA) approved Botox in 1989, one of its initial uses was for treating blepharospasms, a movement disorder of the eyelid muscles.
People with blepharospasms lose control of their ability to communicate with the basal ganglia, a part of the brain that controls eye movements.
“When you have an uncontrolled spasm, those neurons are firing at an excessive rate, and when they fire at an excessive rate, they’re going to cause the muscles to be in continuous spasm,” Yu said.
As a result, a person’s eyelids can become droopy or uncontrollably twitch.
Those abnormal facial movements can be disruptive to daily functions. “If it’s severe, [patients] actually can’t keep their eyelids open enough to see, and then it’s not safe for them to drive,” said Yu.
Botox is used as “a blockade” at the neuromuscular junction, “or where the nerves communicate with their muscles,” she explained. The drug blocks that receptor — “that communication site” — so it cuts off access to the nerves, and “the muscles become a bit paralyzed from it.”
2. Crossed eyes (strabismus)
Crossed eyes, also known as strabismus, was another use for which Botox was initially approved.
Crossed eyes can be a childhood congenital issue or can occur from trauma, such as blunt trauma to the eye area. While crossed eyes can be corrected with surgery, sometimes people get Botox first to relax the muscles and see how the uncrossed eye will look.
People with strabismus who don’t want to undergo eye surgery can use Botox to relax their eye muscles as a longer-term solution as well.
3. Spasmodic dysphonia
Spasmodic dysphonia is a condition that makes sound in the vocal cords sound shaky, strained, or hoarse. However, it’s not considered a speech disorder, but a neurological condition.
People with spasmodic dysphonia receive abnormal signals from the brain and can have uncontrolled spasms that affect their voice.
Dr. Vyvy Young, associate professor in the department of otolaryngology at the University of California San Francisco, explained that injecting Botox into the vocal cords “slightly weakens the muscles [which] helps to sort of smooth and steady the voice out.”
While spasmodic dysphonia can interrupt a person’s ability to communicate, Young said the condition “responds well to Botox treatments” and can change people’s lives.
However, Botox and its Hollywood associations can carry a stigma.
Young said many people “immediately discount... this type of medical treatment as cosmetic, simply because you’ve said the word ‘Botox.’”
But she — and doctors in numerous different fields — are enthusiastic about what it can do for people seeking relief for a variety of issues.
“That people don’t know that [the injection] is an option is sad to me,” Young said.
4. Drooling (hypersalivation)
Botox, usually administered by an ear, nose, and throat doctor, can also treat hypersalivation with a few injections into the salivary glands.
As it does elsewhere on the body, the Botox will paralyze the nerves and stop them from over-producing saliva.
5. Excessive sweating (hyperhidrosis)
For those who experience excessive sweating (hyperhidrosis) of the armpits, hands, feet, head, or face, Botox injections have been shown to be a safe and effective treatment.
In fact, Botox has been shown to decrease sweating in the areas injected by as much as 87 percent. And in cases of palmar (hand) excessive sweating, Botox has been shown to be up to 90 percent effective.
While sweating is necessary for our bodies to maintain healthy temperature levels, repeated Botox treatments for hyperhidrosis have been shown to be safe. The localized areas that are affected by the condition usually only contain a small percentage of the body’s sweat glands.
For example, the underarms contain less than two percent of the body’s sweat glands and have little to do with the body’s overall ability to regulate our temperature.
6. Chronic migraines
People in the throes of a migraine can experience hours of nausea, light sensitivity, and severe pain in their head. This can also include pain in the scalp muscles.
Doctors can administer Botox to the temples on the back of the neck and at the base of the head, to relax the muscles in the area and ease the pain. Another area of treatment can be in the glabellar area, or between your eyebrows.
“People have found that, without knowing, they’re frowning and that contributes to a migraine tension headache,” explained Yu.
7. Bell’s palsy
Bell’s palsy is a facial nerve paralysis that causes one half of the face to droop.
It’s caused when a particular cranial nerve is stimulated, which can occur during pregnancy, if someone has diabetes, or after the transmission of certain viruses, such as Lyme disease.
Although Bell’s palsy is usually temporary, Botox injections can relax the paralyzed facial muscle to help aid recovery.
8. Thyroid eye disease
In particular, this condition can be called thyroid eye disease or Graves’ eye disease.
Among people who have thyroid eye disease, the eyelids can be tightened, giving a look of retracted or bulging eyes.
“Their eyelids don’t come down enough to protect the surface of their eye,” Yu said, noting that the eyes then become uncomfortably dry and interfere with daily life.
“When that happens, we can inject Botox into the eyelid to weaken the muscle that allows the eyelid to be retracted — or open against gravity — and then that also drops the eyelid.”
What you need to know before treating a medical condition with Botox injections
Despite these uses — and many others — Botox is not a miracle drug, said Yu. “It doesn’t work for everybody.” It should simply be viewed as one tool in the chest.
People should also know that they may need to eventually switch from Botox to other products with botulinum toxin, like Dysport, Myobloc, and Xeomin.
“Because [Botox] is a toxin, our immune system does build a tolerance to it,” Yu said. “If you have a cumulative dose in your body over time, the medication starts to wear off some.”
Botox doses for medical conditions are larger than the ones for cosmetic enhancements, she continued. Hence, “all the different companies make the protein a little bit different to trick the immune system” and give people multiple options for seeing the effects of botulinum toxin.
The bottom line
The effects of Botox (and other drugs made from botulinum toxin, such as Dysport, Myobloc, or Xeomin) will vary from person to person.
Generally, the drug wears off after three to four months. This is the case for medical as well as cosmetic purposes. Therefore, Botox is only a temporary solution for its many different uses.
Discuss all options with your doctor or a specialist before deciding if Botox injections are the right treatment for you.