Unpacking The History Of Botox

Feb 20, 2021
08:09 A.M.
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Botox. The name itself conjures up images of money and cosmetic procedures. The eponymous treatment known as Botox is a billion-dollar industry and, by its own right, has earned a place in popular culture without signs of slowing down any time soon.


While the treatment is hailed as a modern win in the medical world, Botox has been around much longer. In contrast, it was not always met with glossy offices in Los Angeles, but by doctors looking to rid it for good.

So when did the switch happen? How did a treatment with life-threatening beginnings become the most popular cosmetic procedure in recent times? This is the messy, strange, and accidental history of Botox.

Botox Originated From Bacteria


Clostridium botulinum. Sound familiar? How about botulism? Well, in May 2017, a botulism outbreak traced to nacho cheese sauce from a gas station caused the death of one person and the hospitalization of ten others in California.

The bacteria causes facial paralysis that can result in death. It was first discovered through an outbreak in Belgium by Belgian doctor Emile Pierre van Ermengem. By the 1920’s scientists at the University of California in San Fransisco tried to isolate the toxin.


However, it would be 20 years later when Dr. Edward Schantz would isolate the botulinum toxin in crystalline form and another 30 before it was used for treatment. As a result, the toxin was administered in the 1970s to treat strabismus (i.e. crossed eyes).

Yet, when studies on the toxin were conducted, researchers realized something strange. Wrinkles in the test monkeys faced a significant reduction in the glabella - the skin between the eyebrows and the nose. Frown lines, anyone?

Botox Procedures Were Discovered by Accident


It was not until 1987 that the toxin was considered for the cosmetic procedure we know today in a purely accidental circumstance. By this time, advancements in medicine had evolved the botulinum toxin for various treatments, notably, eye disorders.

When eye doctor Jean Carruthers carried out a blepharospasm treatment, her patient complained of not receiving treatment in her forehead. This moment would change everything because the patient noticed the diluted toxin faded her wrinkles.

Botox Treatments Were Labeled A Waste of Time


Linda shared the strange request with her husband Alastair Carruthers, a dermatologist whose practice offered cosmetic procedures and skin cancer surgeries. Coincidentally, Alaistair had patients who were frustrated at the lack of a better solution for glabellar lines.

Linda convinced their receptionist Cathy Bickerton into using Botox. Without a doubt, the results spoke for themselves, and Alastair was on board. He had the patients, and Carruthers had the toxin. Unfortunately, the world was not so welcoming.


Linda’s patients were skeptical of the new drug. Furthermore, when the pair presented their findings to the American Society for Dermatologic Surgery, peers labeled Botox a crazy idea that would amount to nothing.

The pair remained formidable, continuing their clinical trials even in the face of unwilling patients. As they soldiered on all while presenting their findings to the American Society for Dermatologic Surgery, their audience slowly grew. In 1993, the Botox boom landed.

Widespread Criticism and Acclaim


The demand was impossible. So much so that people began using the treatment under the radar throughout the 90s, as reported by legendary Allure editor Joan Kron in her 1998 piece Pretty Poison. Many requested the treatment be injected in crow’s feet, necks, and more.

In 2002, following the FDA’s approval for the use of Botox to erase wrinkles, patients were lining up, but with popularity came harsh criticsm. Despite Botox being a highly purified and highly processed form of its origin, it was still referred to as poison countrywide.

Evolved Into More Treatments

The phrase Botox grew a life of its own, becoming a derogatory adjective. Moreso, it was a charged word on its tenth anniversary, a symbol of the criticism it faced as a detractor to the natural aging process. However, like all things, Botox has since evolved.

Doctors have now made a softer approach in administering the treatment. Instead of ridding crow’s feet with aggression, dermatologists are taking a more skilled methodology, embracing the aging process with a nuance likened to an art.

Botox Can Accomplish Even More


Botox has also affected lives in more ways than one. It can be injected into the armpit to treat hyperhidrosis (excessive sweating), bladder dysfunction, and as a study suggests, even treat depression.

The Carruthers are now entirely cosmetic doctors with a concentration on cosmetic medicine. The pair ran a research institute at their offices that coordinates studies on new techniques and procedures. One special benefit for the Carruthers’ office staff? Botox is free.