If a salesman told you a single drug could cure headaches, obesity, sore muscles and even body odor, all for the low, low price of $300, you’d probably think he was selling snake oil. But many scientists now say there’s a drug that does all that and more — Botox. The poison that erases wrinkles may be an effective therapy for many of life’s other bodily indignities. Doctors are administering it for a wide range of ailments it isn’t approved for (yet). “People said using Botox off-label would be a waste of time,” says New York ear, nose and throat doctor Andrew Blitzer. “But a lot more patients are going to benefit.”

The most promising new use for Botox is as a headache treatment. It’s unclear how Botulinum toxin soothes an aching brain — it may inhibit the nerves that transmit pain — but large studies confirm that people get fewer headaches after being Botoxed. Blitzer cites a patient whose migraines kept her from work four days a month, despite conventional drug treatments. He injected Botox into her forehead, and she hasn’t had a migraine since. The drug also works for other chronic nonsinus headaches — doctors simply inject it under the skin, near the pain.

Because Botox weakens muscles, it may also be useful for treating disorders stemming from involuntary muscle clenching, like stroke-induced paralysis, incontinence caused by a spastic bladder and soreness and cramps. A few doctors have injected it into gastric muscle to make obese patients’ stomachs empty more slowly. The effect mirrors that of bypass surgery: patients feel full longer and eat less. Botox may even paralyze sweat glands, which offers hope for people with hyperhydrosis, or excessive, pathological sweating. As trials get underway for these unorthodox treatments, doctors are trying to convince insurers of their efficacy — and safety. Though the long-term effects of off-label Botox use are unknown, the toxin affects only the injected area, and it wears off after a few months. If it’s safe, it may really be a wonder drug.

© NEWSWEEK, April 2, 2003