Off-Label Uses of Botox

Written by Jennifer Gordon, MD, Board Certified Dermatologist on May 10, 2019 No Comments

off label botox uses

When most people think of Botox, the first thing that comes to mind is wrinkles. This makes sense as Botox is a revolutionary non-surgical treatment that was developed many years ago, but continues to be one of the most popular cosmetic treatments to fight signs of aging.

Botox, however, is more than just a wrinkle solution. Since its early development, the Food and Drug Administration (FDA) has approved Botox to treat a number of additional conditions including migraines, eyelid spasms, hyperhidrosis (excessive sweating) and excessive neck pain. Before FDA approval, the efficacy for Botox in treating these conditions was determined when physicians used the product in an off-label manner (i.e. the use of a prescription drug for a condition other than what it has been officially approved for).

The off-label usage of Botox continues today, with many physicians utilizing the revolutionary botulinum toxin to address new and under-treated issues. Here are several current off-label uses for Botox:

Eyebrow Lift

A small amount of Botox can be injected into the orbicularis oculi muscle, which is a muscle that surround the eye and is often the culprit responsible for sagging eyebrows. When injected, Botox weakens the muscle resulting in the eyebrow becoming elevated or lifted.

Nose Lift

Similar to its effect on eyebrows, Botox can be injected into the bridge of the nose to raise the nasal tip. Botox can be used in combination with other dermal fillers to enhance the appearance of the nose. See our post on liquid rhinoplasty for more information.

Facial Slimming

For patients seeking a slimmer facial profile appearance, Botox can be injected into the masseter muscles in the cheek and jaw area. The weakening of these muscles causes them to appear thinner, creating a slimmer and contoured jawline with a potentially more feminine appearance.

Lip Lift

Botox can also be used to create a projected appearance of the lips (sometime called a Botox Lip Flip). Utilized either alone or in conjunction with fillers, Botox can provide a fuller pout by flipping out the lip line and gently rolling the lip outward. This can also help with the fine lines around the mouth.

Gummy Smiles

The “gummy smile” occurs when the upper lip is excessively elevated showing off a large portion of the gums when smiling. Injecting Botox into the upper lip weakens the retractor muscles, thus lowering the lip line to produce a more aesthetically balanced smile.


Early studies of off-label Botox usage to address acne show that injecting a small amount of Botox into active acne lesions may reduce overly active oil production, leading to fewer and less intensive breakouts. While trials are still in their infancy, Botox may one day prove to be an effective acne fighter.

TMJ Disorder

Experimental-stage research has shown Botox to be effective in treating a variety of jaw disorders including severe tension, TMJ Disorder, and lock jaw. Botox is utilized to relax jaw muscles to the point where symptoms are minimized and occurrence is reduced.

Overactive Bladder

Botox is being used by some to manage the symptoms of overactive bladder in instances where traditional medications either cannot be taken by the patient or prove to be ineffective. When injected into the bladder, Botox minimizes most overactive bladder symptoms such as leaking and overly frequent urination.

Jennifer Gordon, MD

Dr. Gordon is Board Certified by the American Board of Dermatology and is a member of the American Society of Dermatologic Surgery (ASDS), the American Academy of Dermatology, the Dermatology Foundation, the Texas Medical Association and the Travis County Medical Society. Currently, Dr. Gordon oversees our South Austin location.

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