Should you get Botox?

The pitch
Sure, I see the anti-aging ads. I see them and I think about how glad I am that I don't have to worry about that stuff yet. Plowing money into miracle wrinkle cures is a pursuit for women who are of a certain age and I'm not there yet. I'm only 20 . . . 20-something . . . wait – I'm 30.

I'm 30. I'm suddenly 30 and realizing that these anti-aging ads are targeted to people of my certain age. Thirty is 'old' now, in the same way that size eight is 'fat'. I know the game – advertisers are raising the bar in order to draw ever-younger and ever-thinner consumers into their market.

The decision
I understand the strategy, but I'm no match for it. I'm a sucker for a sales pitch and within seconds of coming to terms with my age, I'm on the phone to my dermatologist to talk Botox. Despite my husband's objections ("You're going to inject botulism toxin into your head?"), I'm booked for injections.

It's B Day, the day I'm set to get injected, and on a whim I ask Google for Botox news. Less than 1.4 seconds later, my search reveals that Health Canada is reviewing Botox's safety information with mind to increasing the prominence of its warning labels in light of reports of serious side effects when administered for treating spasticity and tense muscles.

Hmm. Less that 1.4 seconds pass before I'm dialing Health Canada for clarification. First of all, who knew Botox was used for medial treatments? In its cosmetic application, botulism toxin (Botox) temporarily paralyzes your frown muscles to make your face look smoother and younger, but in its medical application, high doses are used to help manage over-contractions and muscle spasms caused by conditions like cerebral palsy.

The reassurances
I ask Paul Duchene, Health Canada's media relations advisor, if he'd get cosmetic Botox. "Well . . . I don't think I can answer personally," he hedges. "But I can talk on behalf of Health Canada's position on Botox. We are reviewing the issue of distant toxin spread potentially associated with Botox."

He reminds me that Botox should only be administered at the recommended dose for authorized indications by qualified health care professionals and suggests that patients with questions should contact their physician or pharmacist. "Once our review is completed, if we have any concerns we will advise the public and health care professionals," he promises.

The bottom line: According to Duchene, "There have been no confirmed cases of distant toxin spread related to Botox."

Good enough. But just to be clear, I decide to also ring up Allergan, the global specialty pharmaceutical company that manufactures and commercializes Botox. I chat with spokeswoman Caroline van Hove, a fellow 30-year-old who's also on the Botox train, who reassures me by explaining that when adverse events are reported about a pharmaceutical product, it doesn't mean the product is at fault or causally related to the event. "All it basically means is that an adverse event occurred after treatment with the drug," she says.

"Patients who are treated with Botox for conditions like cerebral palsy receive six to 32 units per kilogram," she explains. In comparison, less than one unit per kilogram is used in aesthetic applications.

"More than a million people have been treated with Botox for cosmetic use and we've never had a single reported death where there was a causal link to Botox," van Hove maintains. "Even serious adverse effects that are reported following the use of Botox for medical uses are very rare."

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