Introduction

This month we are focussing on botulinum toxin, and it couldn’t be more well-timed. With front-page news on “black market botox” bringing fresh calls for regulation last month (see What’s Trending on pages 6-7) and new toxins set to hit the market this year, things are being shaken up on the botulinum toxin front. It’s more than 30 years since Allergan’s wrinkle-busting wonder drug Botox was first FDA-approved for two rare eye muscle disorders – blepharospasm and strabismus in adults - making it the world’s first botulinum toxin type A product to be approved. You can read about the history of toxin, dating back to when it was first discovered during a blood sausage food poisoning outbreak on pages 38-41. Since then, more than 100 million vials of Botox and Botox Cosmetic have been manufactured worldwide for various therapeutic and aesthetic uses, and the term “botox” has gone on to become a household name. Botox itself now has 14 therapeutic indications, more than any other neurotoxin in the world, with yet more off-label uses for toxins widely being used and even claims it helps depression. Read Dr Patrick Treacy’s take on this on pages 66-67. When it comes to aesthetics, Botox has been the backbone of the aesthetics industry, igniting the boom for non-surgical medical aesthetics. Globally it has continued to top the polls for the most popular non-invasive treatment (see News pages 6-14). For the best part of two decades, the market has been dominated by three major players – Merz (Bocouture), Galderma (Azzalure) and Allergan (Botox). But now, for the first time in 14 years, not one but multiple new toxins are set to hit the market, which could be game-changing for the industry (see our feature on the New Kids on the Block on pages 44-48). As well as this, we chat to Dr David Eccleston about his career in aesthetics as one of the UK’s foremost experts on toxins (pages 28-30), Mr Dalvi Humzah shares his insights into the management of toxin complications (pages 62-65), and Emma Davies updates us on the latest legislation (pages 34-36). We also chat with Dr Jonquille Chantrey about the trend for botox among millennials and gen Z-ers and ask, “how young is too young?” (pages 54-56) and speak to David Sines about toxin training (pages 70-72). Add to this some fantastic business advice from Jemma Edwards (p22-24), Pam Underdown (p26-27) and our very own Ron Myers (Ask Ron p20-21) and you’ve got yourself one heck of an issue to get your teeth into. So why not go and grab a cuppa, put your feet up and have a read...