Botox vanity may alter face of drug firms

ON WALL STREET: I like Greta Van Susteren. I met her once in a make-up room in CNN, when she was legal correspondent there. Her sharp face and crooked mouth underlined the feisty nature which made her a favourite TV interrogator during America's great soap opera trials, writes Conor O'Clery.

Greta left CNN in January, lured away by Fox News. When I saw the 47-year-old lawyer for the first time on Fox, I could only think: "Botox!" The wrinkles and bags around her eyes had gone, replaced by a tight smoothness. Greta had transformed herself into a near-clone of other TV news creatures who have effaced themselves with Botox, the injectable drug that is the coming big thing in the United States.

The neurotoxin has been available for treating eye muscle spasms since 1991 but is now much in demand from people who don't want to age. It works by paralysing the muscles that control facial wrinkling when injected around the eyes and forehead, leaving the skin smooth.

The treatment is changing the face of America. In Manhattan facial wrinkles are now as unacceptable as bad teeth among ladies who lunch, and in Hollywood, director Martin Scorsese has complained that - like in The Stepford Wives - it is hard to find an actor with the ability to scowl.

But then, as dermatologist Patricia Wexler in New York, famously said: "A scowl is a totally unnecessary expression."

Botox is about to be approved by the US Food and Drug Administration for cosmetic use, which will allow its maker, Allergan of California, to launch a multimillion dollar advertising campaign for the first time.

This will give a boost to the production of Botox. Like Viagra it is manufactured in the Republic - Allergan has a Botox plant in Westport, Co Mayo - making Ireland the unlikely champion of America's 30 million sagging baby-boomers.

The vanity craze could also give a lift to Elan, the battered Irish pharmaceutical company, which is marketing a different form of the toxin called Myobloc. Myobloc works within hours rather than the several days that Botox needs, though it may not last as long.

One down side of Botox is that the injections have to be repeated every three to four months, at a cost of several hundred dollars. If neglected, that newly acquired, baby-faced, partner might suddenly turn into a crinkly Dorian Gray.

I asked Dr Arnold Klein, a consultant to Allergan who travels the world promoting Botox, about the stories of people ending up with catatonic expressions, or as Robert Redford said, looking "body-snatched". Speaking from Beverly Hills, where his clients are largely actors and actresses, Dr Klein said he could recognise patients with cheap treatment, as their eye lids drooped or they could not frown.

"Lots of people are running bargain Botox clinics for cosmetic enhancement but there are no bargains," he said. "I've seen women who have nice high brows and they flatten them. They have over-injected in their forehead and they can't elevate their brows at all." The ideal is to relax the face enough so the lines will go away, but still be able to have movement, said Dr Klein, who is a professor of medicine and dermatology at UCLA. The treatment was meant to enhance people, "not make them look like Japanese Kabuki dolls, or like they're working for the FBI relocation programme."

Despite the side effects, he believes Botox, already the number one cosmetic procedure in the world, will be very big after approval by the FDA.

The dermatologist has pioneered the treatment in several countries, including Brazil the second biggest user. In Asia he has lectured doctors on how injections of the toxin can replace surgery to make oriental eyes round.

He noted in passing that it was becoming popular with actresses in the Dublin theatre.

"The Christian ethos is that narcissism is a vice, but a certain degree of narcissism is healthy, otherwise we'd never bathe and we'd all dress in paper bags," said Dr Klein. "If you're attractive you get great jobs, a better level of existence."

Greta Van Susteren certainly believed that eye tucks (she denies using Botox) would increase her career span in the wrinkle-free zone of American TV news. But the difference was so startling, she attracted nationwide attention and made the cover of People magazine as a poster-girl for cosmetic surgery. And while Ms Van Susteren is frank about it, many colleagues would rather keep their Botox secrets. "I'm not going to out anyone," she said, "but every person on television has had it done."