Healthcare in the News

Experts Frown on Botox Parties

< June 4, 2002 > They are quickly becoming the Tupperware® parties of the new millennium, but the growing trend of so-called Botox parties—where men and women gather for hors d'oeuvres, chit-chat, and a few wrinkle-removing Botox injections—is bringing out the frown lines of many medical experts.

Ever since the US Food and Drug Administration's (FDA) approval this spring of the use of Botox to treat wrinkles, age-conscious patients are apparently attracted to such events not only by the social aspects, but also by the price, which is usually discounted from the cost of a scheduled appointment. There have been reports of parties popping up across the nation not only at physicians' offices but also at non-medical sites, including gyms and spas, according to the American Society of Aesthetic Plastic Surgery (ASAPS).

However, experts say such treatment is nothing to celebrate and raises significant safety and ethical questions.

In a recent "patient alert" issued by the American Academy of Dermatology (AAD), academy president Fred F. Castro II blasts the notion of a sensitive medical procedure being offered in a party setting.

"A casual social activity for the purpose of administering botulinum toxin, such as a Botox party, is an inappropriate and a potentially dangerous setting for performing medical procedures of any kind," he says.

And ASAPS is equally riled by the party reports, issuing a statement saying parties outside of physicians' offices put patients at risk of "improper technique, inappropriate dosages and unsanitary conditions."

Physicians have worked hard in getting the message out that Botox, which temporarily weakens muscles by blocking nerve impulses, can be a safe and effective treatment for conditions ranging from excessive sweating to incontinence. The recent FDA approval for wrinkles appears to have sealed public confidence.

Now, however, experts are faced with having to add an asterisk to that message, emphasizing the importance of a safe environment for treatment.

"To us, this is a medical treatment that should not be handled in a frivolous way," explains Dr. William Coleman, a clinical professor of dermatology at Tulane University Health Sciences Center in New Orleans and spokesman for the AAD. "The whole idea of taking this substance out of a medical office opens up a Pandora's box of problems."

For one thing, the distractions of a festive party present risks to any medical procedure, Coleman says. "A party atmosphere is not the place for any kind of drug-mixing or thoughtful medical treatment at all."

Then there is the handling of the Botox itself, he adds.

"There are many very important storage procedures for Botox, including where it's stored and how long it's out of a refrigerator. And if it's in a refrigerator, you certainly wouldn't want your bottle of Botox being accidentally placed on top of the pizza you're going to be eating later in the day, for instance," he says.

Dr. Richard Glogau, a clinical professor of dermatology at the University of California, San Francisco, goes one step further in his disapproval. He says even if the gatherings are held in a physician's office, offering medical treatment in the context of a party pushes the bounds of acceptable medical practice.

"Sure, the office may be safe, but the devil's in the details," Glogau says. "If you've got alcohol being served at these functions, it's not only illogical, it's unethical—even American Medical Association guidelines say introduction of the consumption of alcohol immediately invalidates the informed consent process."

Coleman adds that alcohol use while having a Botox treatment could also have medical consequences, such as increased bruising following the procedure.

However, at least one dermatologist who hosts monthly evening Botox parties defends the practice.

Dr. Scott Greenberg, who practices in Winter Park, Fla., says he agrees with all of the associations' objections, but argues that he is able to hold such events without compromising any professional or ethical standards.

"The whole process is really no different than if (patients) came in during the day, with the exception that they experience more of a social situation than a medical one," Greenberg says.

Wine indeed flows at his parties, Greenberg adds, but he emphasizes that patients only have a glass or two—and only after an individual, private consultation that includes signing a consent form. Regarding bruising, Greenberg says that "hasn't been an issue."

Greenberg says he usually charges anywhere from $250 to $450 for a Botox treatment, depending on the area, and those attending the Botox party receive a $50 discount.

Botox parties also appear to represent a nifty solution to an often-frustrating problem with Botox's packaging: the substance is sold in vials containing 100 units, which is enough for about five treatments. Once open and mixed, however, the Botox must be used within four hours, according to specifications by its maker, Allergan. At about $400 per vial, physicians better make sure they've got more than one patient lined up.

"Any Botox I don't use, I just have to throw out," says Dr. Greenberg. "So, it really makes sense to have a number of patients coming in. You can get a much more efficient use of your Botox than if you just have one patient."

With Botox's booming popularity, however, that is a problem fewer and fewer physicians are likely to face. The ASAPS reports that more than 1.6 million Botox procedures were performed last year, and the treatment has moved into the position of becoming the No. 1 non-surgical cosmetic procedure conducted in the United States.

Always consult your physician for more information.


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American Academy of Dermatology (AAD)

American Medical Association

American Society of Aesthetic Plastic Surgery (ASAPS)

American Urological Association

US Food and Drug Administration (FDA)

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Botox for Problems With Urinary Incontinence

For those whose bladders are overactive but not chronic, there is a new use for Botox, a form of the deadly botulism toxin, say researchers at the University of Pittsburgh.

Urinary incontinence is more serious, and researchers found that cells from muscle tissue may prove to be a good treatment.

More than 13 million Americans suffer from this condition, an inability to control the flow of urine. It is especially prevalent in women over the age of 55.

The University of Pittsburgh School of Medicine study involved muscle cells transplanted into the bladder. Called a muscle derived cell (MDC) transplant, the procedure calls for cells to be taken from a skeletal muscle, purified and cloned, and then injected into the bladder of the same individual.

The researchers performed the experiment on mice, in which the purified, cloned, and genetically altered cells were injected into the bladder walls. The mice bladders were evaluated at different points over six months and showed evidence that the new muscle cells were taking hold in the bladders.

Meanwhile, the Botox experiments were performed on 50 humans with a variety of voiding control problems that caused involuntary contraction of the bladder muscle, resulting in incontinence or an inability to completely empty the bladder.

All the patients received Botox injections in the bladder or urethra, the tube that carries urine from the bladder to the outside of your body.

After receiving the Botox, 41 of the 50 people said their incontinence decreased or disappeared. Those improvements occurred within seven days of receiving the Botox and lasted for about six months.

Both studies were to be presented at an annual meeting of the American Urological Association in Orlando, FL, this month.

Always consult your physician for more information.