new warning label on Botox and Botox Cosmetics in Canada that advises the toxin
can spread to other parts of the body, to potentially fatal effect, has been met
by a decided absence of brow-furrowing among those who use the drug
cosmetically, and not only because their foreheads can’t move. They’re confident
that the revised monograph issued this week that states possible symptoms of
“distant toxin spread ” can include muscle weakness, difficulties swallowing,
pneumonia, speech disorders and breathing problems, doesn’t apply to them.
Botox, a muscle relaxant manufactured by Irving, Cal.-based Allergan Inc., has
two uses: medical and cosmetic. It has been licensed in Canada for an increasing
number of medical afflictions, including facial nerve disorders and cerebral
palsy, since 1990. Since 2001, the toxin has been approved to treat ‘frown
lines’ between the eyes, ‘crow’s feet’ and forehead wrinkles. Last February, the
U.S. Food and Drug Administration warned that distant spread phenomenon had been
reported in both in FDA-approved and non-approved uses of Botox. The new
cautionary labelling in Canada stemmed from an investigation launched last
October by Health Canada after five Canadians died following Botox injections.
The agency also looked into eight reports of serious reactions following Botox
treatment. Only one of the 13 had received Botox for wrinkles, and none was
medically confirmed as “distant toxin spread,” Heath Canada reports.
Doctors downplay the risks for the tens of thousands of Canadians who use Botox
for a smoother visage. Nowell Solish, a Toronto-based cosmetic dermatologist and
associate professor at the University of Toronto, says he has fielded a lot of
questions since Health Canada announced its investigation. “I’ve never seen an
instance of ‘distant spread,’” he says. “And there are very few people who
inject more Botox in this country than I do.” Solish, who performs thousands of
injections annually at an average cost of $500 to $1,000 a pop, says “distant
toxin spread” is a risk for those who use the toxin medically to relieve
neurological problems or muscle spasms due to the higher dosages involved. “An
adult with spasticity can receive 800 to 1,000 units while someone coming to me
for a forehead will typically get 50 units,” he says.
Solish says that there can be problems if the toxin is administered improperly:
“If I was someone with a severe medical or neurological problem I would want to
see a doctor who does this all the time,” he says. The new warning hasn’t
frightened cosmetic users, he says. Indeed, the economic downturn has bought new
customers, among them an out-of-work woman he saw this week. “I said, ‘What are
you doing here? This is discretionary funds,’” he says. “She said, ‘I’m
interviewing for jobs and I want to look good. I want to look young; I don’t
want to look old.’ ”
Indeed, injecting the toxin has been normalized as a routine part of looking
one’s best for both women and a growing number of men. Fashion Television host
Jeanne Beker sees the procedure as a necessity in her field: “Most female
broadcasters of a certain age see it as an obligation,” she says. As for the
risk of “distant toxin spread,” Beker’s sanguine: “My doctor assures me it’s
safe and I trust him completely.”
