'Barbie Botox' goes viral but doctors inject caution (updated)

Evolus

01/09/2023 17:39

(Adds detail in paragraph 12 to make it clear toxins may become
less effective for younger women who take Botox early and
regularly)
    By Leroy  Leo
       Sept 1 (Reuters) - The viral trend of "Barbie Botox"
that has women as young as in their 20s rush for toxin-based
procedures to mimic the looks of the movie's lead actress Margot
Robbie may lead to resistance among them and hinder medical use
in future, doctors cautioned.
    The procedure, also known as "Trap Tox", has been widely
used by doctors to inject a class of drugs known as botulinum
toxins, such as Botox, into the trapezius muscles of the upper
back to treat migraines and shoulder pain.
    But since the "Barbie" movie was released in July, there has
been an uptick in demand for use as a cosmetic procedure. The
hashtag BarbieBotox had 11.2 million views on TikTok.
    The procedure "supposedly slims the neck and somehow that
got attributed to the actress that's playing Barbie," Revance
Therapeutics  RVNC.O  President Dustin Sjuts told Reuters in an
interview.
    "They're not treating wrinkles or lax skin. They want less
girth to their neck, a slimmer, more contoured neck," said Scot
Glasberg, president-elect of the Plastic Surgery Foundation, who
practices in New York.
    The approval of such injections for cosmetic purposes is
only limited to procedures involving the face, making the use of
the injection in the trapezius "off-label".
    The U.S. Food and Drug Administration places the
responsibility of "off-label" use on health professionals to
judge such procedures as "medically appropriate".
    Meanwhile, Revance and Evolus Inc  EOLS.O , which make
similar toxins under the Daxxify and Jeuveau brands,
respectively, told Reuters that though "Barbie Botox" has picked
up in recent months, they do not see the trend significantly
boosting sales. 
    Botox maker AbbVie Inc  ABBV.N  declined to comment.
    Historically, people above 40 years would opt for
toxin-based injections - a market estimated to be worth over $3
billion in annual sales in the U.S.
    However, the doctors said they were concerned about a rise
in use among younger women - and six doctors warned that
procedures by underqualified staff at some medispas raised the
risk of complications. 
    
    RESISTANCE RISK
    The jump in use among younger women with typically stronger
immune systems also raises the risk that the products could
become less effective for them over time, said Shilpi Kheterpal,
a dermatologist at Cleveland Clinic.
    "If they're doing high amounts of Botox very frequently...
they may lose its effect over time, not just with Botox, but
with the other products in the market too, because they all have
some similar molecule," Kheterpal said. 
    Doctors also stressed the risk from administration by people
who may not be properly qualified, especially at medispas where
there is little oversight.
    "There are no regulations on the type of doctor that can run
a medispa," said Melissa Levoska, assistant professor of
dermatology at the Icahn School of Medicine at Mount Sinai in
New York.
    "So, a family medicine physician or OB-GYN
(obstetrician-gynecologist) physician can technically open up a
medispa, and now increasingly there are also physician
assistants and nurse practitioners who are doing injections."
    The toxins are generally safe, but a potential risk, if not
injected properly, could be the impact on neighboring muscles
which might weaken them for months.
    "The science isn't quite there yet, in order to support the
clinical profile of it," said Evolus CEO David Moatazedi.
    "However, we do know neurotoxins have been used at doses
significantly higher for therapeutic purposes than the level of
being used for aesthetic purposes and we know the products are
safe."
 

 (Reporting by Leroy Leo in Bengaluru; Editing by Sriraj
Kalluvila)
 ((Leroy.Dsouza@thomsonreuters.com; https://twitter.com/LeroyLeo7))