The Fascinating Evolution Of Botox

1970s

In the 18th century, botulinum toxin was discovered as the cause behind deaths from poisoned meat. Fast-forward to the ’70s, and ophthalmologists first use that same toxin — a muscle-paralyzing neurotoxin we now know as Botox — to treat strabismus (crossed eyes).

1989

Patients find that their crow’s feet smooth out after injections, says dermatologist Dr. Dendy Engelman. By 1989, pharmaceutical brand Allergan buys rights to it, Botox becomes FDA-approved for treating muscle spasms, and docs begin off-label trials on wrinkles.

2002

Botox officially becomes FDA-approved for its first cosmetic use: treating glabella lines, aka the wrinkles on the forehead between and above your eyebrows. Its earliest customers, according to Lisa Goodman of GoodSkin, are mostly women, celebrities, and wealthy patrons.

2006

The first Real Housewives show debuts, and two cast members, Vicki and Lauri, get Botox treatments on air. It’s the first of many cosmetic “tweakments” viewers see on the popular reality series that’s practically become synonymous with a plastic surgery aesthetic.

2004-2013

Botox’s FDA-approved applications expand: Over the years, it gains approval for reducing underarm sweat, crow’s feet, migraines, and urinary incontinence, says Dr. David Shafer.

2015

Botox gets a reputation for “freezing” the face, thanks to movies that make jokes about the injectable. Jennifer Coolidge in A Cinderella Story, for example, says she’s “very, very, very upset” despite not looking like it. “Ah, it’s the Botox,” her character quips.

2019-2020

Experts uncover Botox uses for improving skin quality, like treating rosacea, reducing the appearance of pore size, and healing wounds, according to Dr. Michelle Henry and Dr. Raja Mohan. It also starts to be used for upper lip spasticity (what we know as the lip flip)

2020

More people turn to Botox to relax the masseter muscles due to teeth grinding. “They’ve been asking for these injections for functional support,” Engleman says, rather than its popular use of slimming the face.

2021

Applications extend beyond the face: Henry says Botox can be used for subtle body contouring. “In women desiring a sleeker physique, Botox-induced muscle atrophy can help slim bulkier muscles like the trapezius, deltoids, and calf muscles, which are the most common,” she says.

People are becoming less hush-hush about injections, too. “No one talked about getting Botox 10 to 15 years ago,” says Engelman. “With the perception changing and the de-stigmatization of Botox, nobody thinks anything of it today.”

The Future

Rather than making people look frozen, Engelman says Botox injections have been fine-tuned to achieve a more subtle effect. “The aesthetic is to soften movement, not to completely paralyze it,” she tells Bustle.