Long-term risk of Botox 'unknown', warns doctor

Ladies – and lads – who use the facial treatment Botox have been warned that they could lose more than their wrinkles, because its long-term effects on the brain, nervous system and muscles are unknown.

And a significant number of those who put themselves under the needle to lessen facial and other lines may also be suffering from psychological problems that should be treated instead, doctors say.

A leading neurophysiologist warned yesterday that despite its widespread use, Botox, a derivative of the deadly botulinum toxin, should be treated with care.

"Just because it's fashionable, people shouldn't lose sight of the fact that it's a medical treatment, not a lipstick," said Dr Peter Misra, of the National Hospital for Neurology and Neurosurgery in London.

A number of celebrities, including Celine Dion, Cher, Madonna and even Sylvester Stallone are rumoured to have gone under the Botox needle. Touted as the quickest, safest, least invasive and least expensive treatment in cosmetic medicine, Botox stops facial wrinkles in their tracks because the toxin blocks a key neurochemical transmitter, paralysing the muscles that create lines. Its use has boomed in cosmetic surgery, with global revenues rising from $25m (£15.6m) in 1993 to $310m last year, to an estimated $430m this year.

But a recent study found that nearly a quarter of patients seeking Botox treatment at a dermatology clinic had "body dysmorphic disorder", in which the patient hates their appearance, Dr Misra notes in today's British Medical Journal.

"Psychotherapy was considered the more appropriate treatment for them," he said.

Boots, which has given hundreds of people £200 facial Botox treatments at four of its stores since May, said yesterday that "all our patients are given a 30 to 40-minute consultation before treatment, which only goes ahead if both doctor and patient are happy".