In 2002, the FDA approved botulinum toxin injections for cosmetic use, thereby sparking a cultural phenomenon that ranged from Botox parties, Botox gift cards, and, of course, Botox humor:
According to the American Academy of Dermatology, Botox Cosmetic is a toxin injected into facial muscles causing paralysis that relaxes wrinkles and smoothes foreheads. It has so many other legitimate and off-label uses that it has become the top non-surgical procedure performed in the U.S.
- Market dimensions – Due to the pandemic, the data cited here reflects 2019, a more representative year. In 2019, 5 million injections of botulinum toxin type A, which includes Botox, Dysport, and XEOMIN, were administered, according to the American Society of Plastic Surgeons, making it the top non-surgical procedure performed worldwide.
- Competition – The company that markets Botox, Dublin, Ireland-based Allergan, is the market leader. In 2019, the company generated $3.8 billion in Botox sales, with therapeutic category sales rising 4.9% to $2.1 billion, while cosmetic sales grew 7.4% to $1.7 billion. Allergan’s closest competitors are Galderma Laboratories’ Dysport and XEOMIN, from Germany-based Merz Pharma, but neither is a match for Botox in sheer market awareness.
- Approved treatments – Besides its application for the treatment of movement disorders, botulinum toxin type A was approved by the FDA in 2002 to treat moderate-to-severe frown lines between the eyebrows — called the glabella or the “11s” — and crow’s feet (2013). Botox is also used to treat a number of other ailments, including hyperhidrosis (excessive sweating), migraine headaches, weak bladder symptoms, and muscle stiffness.
- Off-label use – Other uses include horizontal forehead lines, crow’s feet and the tiny “bunny lines” on each side of the upper nose.
Allergan’s Botox revenues have more than doubled from the $1.4 billion recorded in 2008. Not bad for a drug named after the Latin word for sausage, botulus, due to the toxin’s first discovery in poorly prepared sausages during the 18th century. 😍