In 1987, Vancouver doctors Jean and Alastair Carruthers made an accidental discovery that changed the face of beauty and later became a multi-million dollar industry. The couple discovered the cosmetic properties of a toxin normally used by ophthalmologists, which is now known as Botox. Non-cosmetic revenues are likely to increase in the coming years as doctors test Botox for even more unauthorized uses and as Allergan conducts its own studies. Botox has also been shown to prevent chronic migraines, but the exact mechanism of how it works is still unclear. In 1989, the FDA approved BOTOX as the first botulinum treatment for eye muscle problems.
But drug manufacturers are also often aware of unauthorized uses long before those uses are officially recognized by the FDA; after all, that's how Botox ended up being approved for wrinkles. In 2002, Botox obtained FDA approval for so-called frown lines (wrinkles between the eyebrows), marking the first time a pharmaceutical drug was given the green light for a strictly cosmetic purpose. Research continued in the 1980s, and in a Rosenthal and Finzi study, 74 people with major depressive disorder were randomly assigned to receive Botox injections or a placebo. Six weeks later, 52% of people who received Botox experienced a decrease in reported symptoms, compared to 15% of people who received a placebo. This and other research into the unauthorized potential of Botox caught Allergan's attention. He was enthusiastic about Botox's wrinkle reduction potential, he says, and prompted the company to conduct a series of studies on the subject.
Similarly, European doctors were intrigued when they noticed that their patients receiving Botox for facial spasms were sweating less than usual. The variety of conditions for which doctors use Botox is dizzying, reflecting the drug's unique characteristics as much as the pharmaceutical industry's unique strategies to create a blockbuster. Vancouver ophthalmologist Jean Carruthers and her husband, Alastair Carruthers, a dermatologist, pioneered the cosmetic use of botulinum toxin, or Botox, in the late 1980s.
