New Neurotoxins on the Horizon

Toxins isolated from lethal bacteria allow for safe, versatile, and minimally invasive interventions that have revolutionized the field of cosmetic and therapeutic treatments. Botulinum toxins are high-molecular weight proteins produced by Gram-positive, spore-forming Clostridial bacteria. The toxins of 5 distinct strains (A, B, E, F, and G) affect humans. Currently, type A and B toxins are available for the treatment of human diseases in the United States, with type A being the only agent approved for cosmetic use by the U.S. Food and Drug Administration. This article reviews the history of botulinum toxin as a cosmetic intervention, discusses its current role in cosmetic treatment, and provides an update of other neurotoxins on the horizon for therapeutic and cosmetic use.