Although there were studies using different strains of botulinum toxin in the 1800s, the breakthrough in the use of botulinum toxin in aesthetics only became widespread in the 1970s.

It all started when Alan B. Scott, an ophthalmologist, obtained permission from the U.S. Food and Drug Administration (FDA) in 1978 to use botulinum toxin A for the treatment of strabismus. A pharmaceutical company in the United States obtained FDA approval for the use of botulinum toxin A under the trade name Oculinum in 1989 for the treatment of strabismus, blepharospasm, and hemifacial spasm. Two years later, the name was changed to Botox.

By 1992, when Canadian ophthalmologist Jean Carruthers applied blepharospasm treatment to a patient and noticed that the lines between the eyebrows disappeared, and Jean informed her husband, dermatologist Alastair, about this, the use of botulinum toxin for the treatment of wrinkles was ignited. After studies, the FDA approved it for glabellar (between the eyebrows) use in 2002. Subsequently, FDA approvals were obtained for axillary hyperhidrosis in 2004, chronic migraine and upper lip spasticity in 2010, and crow’s feet lines in 2013.

Botulinum toxin is produced by the bacterium Clostridium botulinum. Serologically, there are 8 different types. The most potent of these is type A (BoNTA).