What Happened to Botox (onabotulinumtoxinA)?
Botox, derived from botulinum toxin type A, has transformed from a potent neurotoxin into a widely used medical and cosmetic treatment. Originally approved for therapeutic uses like eye muscle disorders, it gained significant popularity after its FDA approval for cosmetic wrinkle reduction in 2002. Today, under the ownership of AbbVie, Botox continues to expand its indications and market presence, with ongoing innovations in treatment techniques and a growing global demand for both aesthetic and therapeutic applications.
Quick Answer
Botox, a brand name for onabotulinumtoxinA, remains the leading botulinum toxin product globally, widely used for both cosmetic wrinkle reduction and various medical conditions. Owned by AbbVie since 2020, it continues to see strong market growth, driven by increasing demand for minimally invasive aesthetic procedures and expanding therapeutic indications. As of 2026, trends include personalized treatment plans, microdosing, and the exploration of new aesthetic uses like masseter muscle prominence, reinforcing its position as a versatile and evolving treatment.
📊Key Facts
📅Complete Timeline15 events
Botulinum Toxin Described
German physician Justinus Kerner publishes the first comprehensive description of botulinum toxin, referring to it as 'sausage poison' due to its association with food poisoning.
Clostridium botulinum Identified
Professor Emile Pierre van Ermengem of Belgium identifies the bacterium Clostridium botulinum, which produces the neurotoxin.
Botulinum Toxin Type A Isolated
Dr. Herman Sommer at the University of California, San Francisco, successfully isolates botulinum toxin type A in a purified, crystalline form.
Therapeutic Research Begins
American ophthalmologist Dr. Alan Scott begins researching botulinum toxin type A as a potential treatment for strabismus (crossed eyes) and blepharospasm (eyelid spasms).
Cosmetic Effects Noticed
Canadian ophthalmologist Dr. Jean Carruthers and her dermatologist husband Dr. Alastair Carruthers observe that patients treated with botulinum toxin for blepharospasm also experienced a reduction in frown lines.
First FDA Approval (Medical)
The FDA approves botulinum toxin type A (marketed as Oculinum, later Botox) for the treatment of strabismus and blepharospasm. Allergan acquires the rights to the product.
Oculinum Renamed Botox
The product Oculinum is officially renamed Botox by Allergan, Inc.
FDA Approves Botox Cosmetic
The FDA approves Botox Cosmetic for the temporary improvement of moderate to severe glabellar lines (frown lines between the eyebrows), marking its entry into the aesthetic market.
FDA Approval for Chronic Migraines
Botox receives FDA approval for the prevention of chronic migraines in adults, further expanding its therapeutic applications.
Expanded Cosmetic Indications
Botox Cosmetic receives FDA approval to treat crow's feet lines, adding another key aesthetic indication.
Further Cosmetic Expansion
FDA approves Botox Cosmetic for the temporary improvement of moderate to severe forehead lines, making it the only neurotoxin approved for three facial aesthetic areas.
AbbVie Acquires Allergan
AbbVie completes its $63 billion acquisition of Allergan plc, bringing Botox and Allergan's other aesthetic and therapeutic products under AbbVie's portfolio.
Global Treatments Exceed 9 Million
Over 9 million Botox treatments are performed worldwide, solidifying its position as the most popular non-surgical cosmetic procedure globally for the third consecutive year.
FDA Accepts sBLA for Masseter Muscle Prominence
The FDA accepts AbbVie's supplemental Biologics License Application (sBLA) for BOTOX® Cosmetic for masseter muscle prominence, indicating a potential fifth aesthetic indication.
European Approval for Boey
Allergan Aesthetics receives approval from the European Commission for Boey (trenibotulinumtoxinE) for the temporary improvement of glabellar lines in adult patients.
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🔍Deep Dive Analysis
The journey of Botox began in the late 18th and early 19th centuries with the identification of botulinum toxin as a cause of food poisoning. German physician Justinus Kerner first described the toxin's effects in 1822, and in the 1920s, Dr. Herman Sommer isolated botulinum toxin type A in purified form. Decades later, in the 1950s and 1960s, scientists discovered its ability to block neuromuscular transmission, paving the way for therapeutic applications.
In the 1970s, ophthalmologist Dr. Alan Scott pioneered research into using botulinum toxin type A to treat strabismus (crossed eyes) and blepharospasm (eyelid spasms). This work led to the FDA's initial approval of Oculinum (later renamed Botox) in 1989 for these eye muscle disorders. A pivotal moment for its cosmetic future occurred in 1987 when Canadian doctors Jean and Alastair Carruthers observed that patients treated for facial spasms also experienced a reduction in frown lines. This serendipitous discovery spurred research into its aesthetic potential.
Botox's cosmetic breakthrough arrived in 2002 with FDA approval for temporarily improving moderate to severe glabellar lines (frown lines between the eyebrows). This approval marked a significant turning point, transforming Botox into a household name and the world's most popular non-surgical cosmetic procedure. Subsequent FDA approvals expanded its aesthetic indications to include crow's feet (2013) and forehead lines (2017). Beyond aesthetics, its therapeutic uses also broadened to include chronic migraines (2010), excessive underarm sweating (hyperhidrosis, 2004), cervical dystonia (2000), upper limb spasticity (2010), and overactive bladder (2011).
In May 2020, pharmaceutical giant AbbVie completed its transformative $63 billion acquisition of Allergan, the original developer and marketer of Botox. This acquisition brought Botox and Allergan's other leading aesthetic brands, like Juvederm, under AbbVie's diversified portfolio, aiming to enhance long-term growth and innovation. The botulinum toxin market continues to exhibit robust growth, with global market size valued at approximately USD 13.2 billion in 2025 and projected to reach USD 14.4 billion in 2026, growing at a CAGR of around 9.9% from 2026 to 2033. North America remains the dominant market, accounting for nearly half of the global revenue.
As of 2026, Botox continues to evolve with new trends and applications. The aesthetic market is seeing a shift towards more natural-looking results, personalized treatment plans, and microdosing techniques, particularly for younger patients seeking preventative treatments. Advanced technologies like AI imaging and 3D facial mapping are being integrated to enhance precision and safety. Competitors like Dysport, Xeomin, Jeuveau, and the longer-lasting Daxxify also vie for market share, driving continuous innovation. Furthermore, AbbVie is actively pursuing new indications, with the FDA accepting its sBLA for BOTOX® Cosmetic for masseter muscle prominence in August 2026, potentially opening a new category in non-surgical facial contouring.
What If...?
Explore alternate histories. What if Botox (onabotulinumtoxinA) made different choices?