"My wife has lots of interesting ideas," says the dermatologist Dr Alastair Carruthers. "But when she came home from work one day and suggested injecting my receptionist with the deadliest chemical known to humanity, my jaw dropped. "It will make her look less frazzled," Jean Carruthers exclaimed.
Within hours of having her forehead injected with Botox, a purified form of the botulism bacteria, Kathy, the receptionist, "still felt frazzled, but her angry wrinkles had gone".
That was back in 1987, when use of botulinum toxin A for cosmetic treatment was totally unheard of. Botulinum toxin is recognised as a potentially fatal poison. During Operation Desert Storm, in August 1995, the Iraqis were found in possession of 19,000 litres of botulinum toxin, enough to wipe out the entire world population. So it is not surprising that the earliest studies of the toxin were aimed at preventing and combating its deadly effects, rather than looking for therapeutic uses.
But today, Botox has become the most talked-about and fashionable form of anti-ageing treatment on the market. Dr Carruthers estimates that nearly a million people across the world are now having Botox treatment. According to reports, celebrities such as Patsy Kensit, Elizabeth Hurley, Madonna, Meg Matthews and Kylie Minogue are all having Botox treatment. In the UK, around 4,000 people a month are seeking treatment - an increase of 150 per cent since last year. So how did it go from a feared chemical- warfare poison to a favoured beauty treatment?
In the late Sixties, Dr Alan Scott, an ophthalmologist at the Smith-Kettlewell Eye Research Institute in San Francisco, had found that botulinum toxin could be used as a safe and effective treatment for a variety of neuromuscular disorders characterised by involuntary muscle contractions or spasms.
After studying Dr Scott's work, Jean Carruthers, also an ophthalmologist, began using Botox to treat patients suffering from blepharospasm - the uncontrollable contraction of the eyelid muscles that can force the eye to close causing functional blindness. It was then that she and her husband noticed its potential for reducing wrinkles.
"After we had treated a few patients, I began to realise the cosmetic implications of Botox," says Dr Carruthers, dermatologist and clinical professor at the University of British Columbia in Vancouver. "I couldn't believe it. I knew it was going to be an absolute winner."
By 1989, Botox had been approved by US Food and Drug Administration for use in treating blepharospasm and strabismus, the misalignment of the eyes (squint). Meanwhile in Canada, the Drs Carruthers had begun to use the drug for cosmetic purposes. But it wasn't until the mid-Nineties that "word of mouth" about Botox began to take hold.
Amanda Riley, 38, a city banker from west London, is a fairly typical Botox user. She started treatment two years ago after advice from a friend. "I had begun to get quite self-conscious about the lines on my forehead, but wasn't quite brave enough to face the thought of having a facelift," she says. "I'd tried every pot of face cream going. I was attracted to Botox because it was non- invasive. After the treatment, I could see a definite improvement, my lines had smoothed out and my skin looked taut on my forehead. I felt much younger and much more confident."
Amanda now has regular Botox sessions three times a year with Dr Mike Comins, at the Lifestyle clinic, in Knightsbridge, London.
"Botox is very popular because it works and the side-effect profile is very small," says Dr Comins. "It can also be reversed and it wears off. It temporarily stops the nerve working in specific areas. But like any other tissue, it grows back again in three to four months."
For cosmetic treatment, Botox is injected in to the facial muscle, usually along frown lines, laughter lines and crow's feet. …