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Botox, and its smaller market competitors of Dysport and Xeomin, have literally changed the face of wrinkle treatments. Weakening or paralyzing select facial muscles has led to a host of undesired facial expressions being reduced. Although these effects are not permanent, the aesthetic improvements provided has made Botox a billion dollar drug in sales. This has led, perhaps not surprisingly in the competitive anti-aging and cosmetic market, to a variety of marketing efforts to capture patients that have discrete facial expression issues.

The most recent publicity surrounding ‘Pokertox’ is a prime example of a marketing strategy on the well known effects of Botox. This is the application of Botox to supposedly enhance a card player’s face to create a ‘poker face’, masking any facial expressions that may reveal what type of hand they may have. This appears to be for the more professional poker players who may know what their unconscious facial expressions (tells) are. This would have to involve such expressions as eyebrow raising, squinting or corner of lip changes, all areas that Botox can alter facial expressions well. Given that the effects of Botox is only temporary and its costs, one would have to assume that these treatments would only be for the most successful poker players.

Not being a poker player or a gambler, I would have no idea if Botox could really be effective for this type of facial expression management. While there may be uncertainty as to its effectiveness, there is no uncertainty that it is a publicity gimmick.  The simplicity of the Botox name lends itself to a variety of spinoffs based on its name. You can just about put anything in front of the word Tox and come up with a type of Botox treatment. Pokertox is not the first that has used this approach. ChinTox, Notox and Eyetox are some of the examples of doctors and skin care manufacturers capturing on the successful and well known effects of Botox.

If mimicry is the sincerest form of flattery, then Botox can expect more Tox variations in the future. The company undoubtably doesn’t mind any marketing that helps promotes Botox use although it may be less pleased with any non-injection product that suggests its effects are remotely comparable to an injection treatment. ‘Toxology’ is alive and well in facial aesthetics with new names but not necessarily new effects.

Dr. Barry Eppley

Indianapolis, Indiana

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