What is Botox Used for? 6 Surprising Applications

Botox cosmetic (onabotulinumtoxinA) first gained popularity as a cosmetic treatment for facial wrinkles after a 1994 study. It became FDA approved for the treatment of frown lines in the early 2000s. It’s also available as another product, simply called Botox. This product isn’t approved for wrinkles, but has many other uses. In this article, we’ll refer to these two products (Botox Cosmetic and Botox) as just “Botox.”

So besides wrinkles, what else is Botox used for? It may surprise you to learn that Botox — a bacteria’s toxic byproduct — could have so many uses in the medical world. 

Here we’ll discuss six surprising FDA-approved uses for Botox beyond cosmetic treatments. And we’ll also talk about other promising uses that may be approved in the future.

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What is Botox?

Botox is made of a toxin from the bacterium Clostridium botulinum. This toxin can cause botulism in large amounts (a potentially fatal disease that affects the body’s nerves). But if the toxin is given in small, targeted amounts — as is the case with Botox — you can experience medicinal benefits while avoiding serious illness. 

When used in small amounts and isolated to certain muscles, Botox prevents nerves from firing. This causes muscle relaxation.

6 FDA-approved Botox uses besides wrinkles

Although Botox is mainly known for treating wrinkles, researchers have discovered that it can be useful for treating many other conditions. We’ll take a look at other FDA-approved Botox uses below.

1. Migraines

Migraines affect more than 10% of people worldwide. They can make life difficult for those who experience them. Botox is FDA approved to prevent headaches in people with chronic migraines. Your migraines may be chronic if you have headaches that last 4 hours or longer during 15 or more days per month.

The American Headache Society recommends Botox injections as a treatment option for chronic migraine prevention. Available evidence supports this recommendation. A review of 28 clinical trials found that Botox injections reduced the number of migraine days in people with chronic migraines (by an average of 2 days per month). And it may reduce the severity of migraine episodes as well.

When you receive Botox injections for migraine prevention, it blocks the nerves in those areas from sending pain messages to your brain. You’ll typically receive it every 3 months. But some people may improve to the point where no additional treatments are needed.

2. Excessive sweating

Excessive sweating (hyperhidrosis) is a chronic condition that can cause physical and mental distress. Botox is FDA approved for adults with severe hyperhidrosis who don’t get enough relief from products you apply to the skin (like antiperspirants).

Botox works for hyperhidrosis by preventing your nerves from releasing a chemical that promotes sweating. And it’s been shown to be effective. For example, a 2001 study of over 145 participants found that Botox reduces underarm sweating. Additionally, 98% of the study participants said they would recommend the treatment to others.

Botox tends to reduce sweating for about 6 to 9 months after an injection. So repeat dosing is often necessary after this time has passed.

3. Spasticity

Botox is approved to treat limb spasticity in people who are at least 2 years of age. Spasticity refers to an abnormal increase in muscle contractions (tightening) that aren’t controllable. Spasticity is a bothersome symptom of many medical conditions, including:

• Multiple sclerosis (MS)

• Cerebral palsy

• Trauma to the brain or spinal cord

• Stroke

Botox injections can decrease spasticity by blocking the release of a chemical that triggers muscle contraction. Botox doses typically need to be repeated. But they’re usually spaced at least 12 weeks apart. 

4. Bladder problems

Botox is FDA approved to treat overactive bladder in adults. It’s also approved to treat overactive bladder associated with a brain condition like MS in adults and children who are at least 5 years old.

One of the main causes of overactive bladder is excessive bladder muscle contractions. Botox can help relax the bladder muscle. This allows the bladder to fill more completely and reduces the urge to pee frequently.

Botox isn’t a first-choice option for overactive bladder. But if first-choice options like anticholinergic medications don’t work, Botox is an option. It’s been shown to improve symptoms like inability to control when you pee. It’s also been shown to increase the capacity of your bladder to hold urine and decrease pressure in the bladder.

It’s recommended to repeat Botox treatment for overactive bladder when the effects start to wear off, but no sooner than 12 weeks from the previous treatment. 

5. Neck spasms

Neck spasms — sometimes referred to as cervical dystonia — are caused by muscle nerves sending signals to the brain to contract unnecessarily. Botox can help treat cervical dystonia by

temporarily relaxing the affected muscles. This can improve neck pain and help correct an abnormal head position.

The injections are given into the neck area. It takes about 6 weeks for full improvement to occur. And usually, the treatment needs to be repeated after a minimum of 3 months. 

A 3-year study that followed participants receiving Botox treatment for cervical dystonia showed that 90% were satisfied with the relief Botox provided at its peak effect. And around 55% were still satisfied with the results just prior to their next treatment (usually between 12 to 16 weeks after the last treatment). 

6. Eye problems

Botox injections are also FDA approved for certain eye problems. This includes crossed eyes (strabismus) and eye twitching (blepharospasm) caused by involuntary muscle contractions in people who are at least 12 years old. Botox injections have been shown to be effective for both these eye issues.

Treatment results can usually be seen within a few days and peak about a week or two after treatment. Treatment with Botox for strabismus usually lasts about 2 to 6 weeks. Treatment with Botox for blepharospasm usually lasts about 3 months.

The medication was approved for strabismus based on an open-label trial with over 600 people. Over half of the participants experienced a benefit at least 6 months after the injection.

Other potential Botox uses

Besides its FDA-approved uses, Botox has been studied for other conditions it hasn’t been approved for yet. Here we’ll discuss conditions for which Botox has not yet been FDA approved, but has research suggesting its potential.

Depression

Several studies have explored Botox facial injections for treating depression. Researchers think this could be because our facial expressions may be linked to how intensely we experience emotions. This is called the facial feedback hypothesis. 

Based on a 2018 review of six clinical trials, it’s possible that Botox facial injections could be a promising treatment for depression. And another review of over 40,000 Botox treatments for multiple indications found that people who had Botox injections experienced less depression than people who received different treatments for the same conditions. This may indicate that Botox injections, regardless of where they’re injected, can relieve depression. And it also suggests there’s likely other mechanisms involved besides the facial feedback hypothesis. But more high-quality research must be done to determine its possibilities.

Male sexual dysfunction

Botox has been studied for use in male sexual dysfunction, including erectile dysfunction (difficulty keeping an erection) and premature ejaculation (when ejaculation happens very quickly). It may help improve erectile dysfunction by relaxing muscles in the penis, increasing blood flow to the penis. And it may help to treat premature ejaculation by slowing muscle contractions.

Some evidence has shown that Botox can help treat erectile dysfunction and be an effective add-on treatment to other erectile dysfunction treatments. But these studies have been small.

And small studies of Botox for premature ejaculation have also shown promising results. But we need larger studies before we know for sure.

Temporomandibular joint (TMJ) dysfunction

Temporomandibular joint (TMJ) disorders are a group of conditions that cause joint dysfunction and pain. Botox may help treat TMJ disorders by relaxing the jaw muscle, which may help provide relief of symptoms. Several studies have looked at Botox as a TMJ treatment. These studies have found that Botox relieves TMJ symptoms like jaw pain and joint clicking sounds.

As with the conditions mentioned above, more studies are needed to confirm the benefits of this treatment. 

Gynecological conditions

Botox injections have shown promise in treating a variety of gynecological issues, including abnormal vaginal contractions, vulvodynia (pain around the vaginal opening), and chronic pelvic pain. Several studies involving women with these conditions have shown encouraging results. But as with all off-label Botox uses, we need more definitive research.

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Written by:

Sarah Lobello Pearson, PharmD

Sarah Pearson is a practicing pharmacist with over 10 years of experience in the field. She received her doctorate in pharmacy from the University of Georgia in Athens, GA.

Edited by:

Amy B. Gragnolati, PharmD, BCPS

Amy Gragnolati, PharmD, BCPS, is a pharmacy editor for GoodRx. Amy currently holds her pharmacist license in Georgia and California.

Reviewed by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

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