Botox Uses – Indicated Uses + Surprising Off-Label Uses

Written by Gregory Nikolaidis, MD, Board Certified Dermatologist on October 21, 2014 11 Comments

uses of botox

When most people think of Botox the first thing that usually comes to mind is wrinkle reduction. Indeed, Botox (technically called onabotulinumtoxinA) is the world’s most popular treatment for eradicating wrinkles and fine lines.  The toxin is specifically FDA approved for treating frown lines between the eyebrows (glabellar lines) and lines around the eyes (crows feet).

In addition to being the gold standard for wrinkle reduction, Botox can also be used to treat a variety of issues, both cosmetic and non-cosmetic. Below is a list of conditions that Botox has been used to treat.

Other FDA Approved or Indicated Uses of Botox:

  • Eyelid Spasms – The first use of Botox that was approved by the FDA (in 1989) was for the treatment of certain types of eye muscle problems or abnormal spasm of the eyelids (blepharospasm) in people 12 years and older.
  • Excessive Sweating – Botox is a temporary treatment option for sufferers of hyperhidrosis or excessive sweating. Botox is injected into the sweat glands just under the skin to temporarily block the chemical signals from the nerves that stimulate the sweat glands. Botox prevents unnecessary sweating for an average period of six to seven months.
  • Migraines – In 2013, Botox received FDA approval for the treatment of migraine headaches. The treatment involves the injection of Botox into seven different locations including the temples, neck, shoulders, and forehead. Clinical testing has indicated that Botox dramatically lowers the instance of migraines even in the most severe cases. While the medical community does not know exactly how Botox eases migraine symptoms, the most popular theory is that it prevents pain signals from reaching nerve endings.
  • Chronic Neck and Cervical Muscle Pain – A 2012 study showed that Botox injections significantly improved pain levels and overall quality of life for sufferers of chronic neck pain that happens with cervical dystonia (CD). When Botox was injected into target muscles it blocked signals that caused unnecessary muscle tightening; the causation of chronic pain. Botox was shown to ease pain without the prolonged side effects of other treatment options.
  • Overactive Bladder – Botox is often used to treat several incontinence and overactive bladder symptoms in adults over 18 years of age when other types of medications do not work or cannot be taken.  Specific symptoms may include a strong need to urinate with leaking or wetting accidents, a strong need to urinate right away, and frequent need to urinate.
  • Muscle Stiffness – Botox is used to treat increased muscle stiffness in elbow, wrist, and finger muscles in people 18 years and older with upper limb spasticity.

Off-Label Uses of Botox:

Note that Botox is not FDA approved or indicated for the issues below, but that some physicians do treat with off-label use of the product.

  • Eyebrow Lift – Botox can provide a quick and less dramatic version of the popular brow lift surgical procedure. A small amount of Botox is injected into the muscles responsible for pulling the eyebrows down. As these muscles become weakened, the eyebrows become lifted, thus elevating the brow.
  • 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, lowering the lip line to produce a more aesthetically balanced smile.
  • Jaw Reduction – Botox can be used to perform jaw reduction (commonly called jaw line softening). Injecting Botox into the masseter muscle (the primary muscle used in chewing actions) reduces its overall size; transforming an overly square and masculine appearing jawline into a more feminine oval or heart shape.
  • Jaw Tension, Lock Jaw, and 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. When injected into the jaw Botox relaxes the facial muscles; both reducing occurrences and minimizing symptoms.
  • Depression – Early testing has shown that a single instance of Botox injection can serve as an effective treatment for depression. Researchers in Germany linked the functioning with facial muscles to emotional well-being.  At a press conference for the 2014 American Psychiatric Association annual meeting study researcher Tillmann Kruger said “Our emotions are expressed by facial muscles, which in turn send feedback signals to the brain to reinforce those emotions. Treating facial muscles with botulinum toxin interrupts this cycle.”

Gregory Nikolaidis, MD

Gregory A. Nikolaidis, MD is a Board Certified Dermatologist. Dr. Nikolaidis serves as a Botox® Cosmetic Black Diamond Level National Education Faculty Member, and he has additionally trained numerous physicians on Sculptra Aesthetic, Radiesse, Restylane, and other non-invasive procedure techniques. He was among the first cosmetic surgeons in the United States to offer Smartlipo laser body contouring.

11 Responses to “Botox Uses – Indicated Uses + Surprising Off-Label Uses”

  1. Avatar Elaine says:

    Thank you for writing this, its a very interesting post. I did not know Botox was being used for so many issues.

  2. Avatar Rhonda says:

    What is better to get rid of the wrinkles on your face above your lip? Fraxel, botox, or other methods? I had botox before and it left my lip muscles unable to smile. What would you recommend?

    • WD Staff WD Staff says:

      Hi Rhonda,

      Thanks for reading our post and submitting your great question! We would love to have you come in for an in-office assessment. That would be the best way to determine your best option of treatment. Please give us a call if you would like to schedule an appointment!

      From your comment, it seems like you may want to try a filler, especially if Botox was previously ineffective. However, laser treatments could also be effective.

      WD Staff

  3. Avatar Ariana says:

    My face looks dull and there is a lot of dryness and wrinkles on my face. I have used many cosmetic products and the consequences are wastage of money and time. I just want to know that botox treatment is really effective???

  4. Avatar Mark says:

    I never knew that Botox has been shown to reduce severe migraines! I’ve beem getting a lot of headaches ever since I started my new job. I’ll have to look into this more!

  5. Avatar Penelope says:

    This is some really good information what botox can help you with. It is so great to know that you can get botox to help with migraines. My mother and brother get really bad migraines so this is a good thing for them to know.

  6. Avatar Essence says:

    Great content on the uses of Botox. Thanks for sharing.

  7. Avatar Larry says:

    I didn’t realize there were so many uses for Botox!

  8. Avatar Skylar says:

    I had no idea that you could use botox to help get rid of migraines. My mother has really painful migraines. I think I’ll suggest that she consider getting botox to help with them.Thanks for this info 🙂

  9. Avatar Vivian says:

    Wow, it’s interesting that there are many different uses of botox approved by the FDA such as migraines. I didn’t know they inserted botox into so many different areas like the neck and shoulders. I am looking into getting help to tone down my excessive sweating and your article makes me think botox might be a good choice

  10. Avatar Grace Turner says:

    I didn’t realize that botox has so many alternative uses. I’ve been noticing migraines lately. Perhaps I can find a doctor that offers botox injections as a treatment for migraines.

Leave a Reply