摘要

Objectives: Along side cosmetic indications we can expand the use of neurotoxins in treating non cosmetic indications like hyperhidrosis,Itch disorders,scar correction,inverse psoriasis,eczema,alopecia,post herpetic neuralgia and many others.It is a wonder drug and has promising outcomes in both cosmetic and non cosmetic therapeutic indications.It is still in the process of discovering newer indications and crossing new frontiers. Introduction: A German physician Justinus Kerner (1786-1862) first developed the possible therapeutic use of botulinum toxin, which he called “sausage poison”. BoNT-A received US FDA approval for treatment of cervical dystonia.The acceptance of BoNT-A use for the treatment of different chronic pain disorders is growing but is US FDA approved only for chronic migraine.In 2010- the US FDA approved onabotulinumtoxinA to treat spasticity in the flexor muscles of the elbow, wrist, and fingers in adults with stroke, traumatic brain injury& the progression of multiple sclerosis Materials / method: Mechanism of action of BTX is chemical denervation or preventing the release of acetylcholine into the synaptic cleft.The heavy chain binds to the receptors on the cholinergic nerve endings. This is followed by endocytosis of the molecule and attachment of the light chain to the soluble N-ethylmaleimide-sensitive fusion (SNARE complex) protein receptors after getting cleaved from the heavy chain.The binding of BT to these receptor proteins prevents the attachment of acetylcholine vesicles to the nerve endings and its further release into the synaptic cleft. Results: There are few non cosmetic indications that can be treated with BTX .Hyperhidrosis,Hidradenitis suppurativa,Post-herpetic neuralgia,Androgenetic Alopecia,Hypertrophic scars/keloids and Trigeminal Neuralgia are few to respond well. Conclusion: Botulinum toxin is a wonder drug with multiple therapeutic and aesthetic indications and still discovering newer ones and crossing newer frontiers adding quality and value to life.