THE LINE STOPS HERE; BUSINESS BOOMS FOR BOTULISM-BASED WRINKLE CURE.

Byline: Lynda Gorov Boston Globe

She hadn't frowned since October, but Mary Jo Frazier Cambou was frowning now. At least she was trying to scrunch up her brow.

``Let's have you frown and relax,'' Dr. Joshua Wieder urged. ``Here's the first needle stick. Now gently frown again.''

The procedure was over in seconds. To eliminate those unsightly lines between the eyes, Wieder had injected Frazier Cambou with a deadly poison that will paralyze the offending muscle for four months or more. She wouldn't have to frown again - wouldn't be able to frown again - during that time.

``This is not a big deal,'' said Frazier Cambou, 43, a dentist whose practice includes plenty of Hollywood types. ``I have no problem with aging, but when I looked at pictures and saw those gashes between my eyes, I thought, `I'm doing it.' ''

``It'' is Botox (pronounced BOE-tox), a drug made from the same toxin that causes botulism. Like Frazier Cambou, so many men and women are seeking the treatment in Southern California that it's become a verb, as in ``I'm getting Botoxed during lunch.'' Dermatologists talk in terms of hundreds, even thousands of patients each. Nurses at some medical practices boast about a new perk: free injections on what they fondly refer to as ``Botox night.''

Growing popularity

Dr. Debra Luftman, who's been offering the procedure at her Encino office for two years, has seen people of all walks come in for a Botox injection.

``We have everything from housewives to CEOs of businesses,'' said Luftman, who's also a clinical instructor of dermatology at UCLA. ``It's becoming a very popular procedure because you get immediate results.''

Sandy Goor of Calabasas, one of Luftman's patients, last week returned for her third injection of Botox in a year.

It was about five years ago that Goor began to notice the furrow in her brow deepening into what she calls ``this horrible frown mark.''

But it was her 8-year-old daughter's comment that spurred Goor to action.

``My daughter always made the comment to me, `Mom, when I grow up, am I going to have a crack in the middle of my face like you?''' Goor recalled.

The sales representative doesn't have second thoughts about her choice. Neither does her daughter.

``She definitely notices a difference,'' Goor said laughing. ``And I do.''

Despite its rather frightening origins, dermatologists say that Botox is a safe, temporary way to soften or eliminate crow's feet, forehead wrinkles, and frown lines between the eyes. Only minuscule amounts are injected, and a monitor attached to the needle helps doctors locate the muscles that need paralyzing. Patients can still smile afterward, because the lower muscles of the face still function, but with less crinkle and wrinkle than before.

``It's great for people who frown very deeply and don't like it,'' said Wieder, who has been using Botox on patients for about five years. ``Frowning often gives you a sinister look. Some people like that, I suppose, if you're Robert De Niro and can earn a living with that look. But most people don't like the way they're perceived when they're scowling.''

Pricey proposition

Eliminating that scowl, however, can be expensive. Botox wears off in three to six months, and doctors charge $350 to $400 for the first area injected. Paralyzing all three areas can cost upward of $600 - at least three times a year. On the plus side, dermatologists say the muscles retrain themselves over time and some people require only twice-yearly treatments.

Patients say the money is well-spent, even if it's not covered by insurance.

The typical patient, doctors say, is a 30- to 60-year-old woman, although this being image-conscious Los Angeles, some are as young as 25. Men get Botoxed, too, especially in the forehead area. Once past the idea of injecting poison into their faces, few who start the treatments say they would consider stopping.

Botox, of course, was not originally intended for cosmetic use. Doctors using it to treat eye tics and crossed eyes stumbled on the wonders it does for wrinkles. As Alastair Carruthers, a Vancouver dermatologist who is known as one of the gurus of Botox, tells it, one of his ophthalmologist wife's patients discovered that the drug eliminated both her eye tics and the wrinkles between her eyebrows. She loved the way she looked.

``My wife said to me, `One of my patients said that when I inject her in the brow area, she gets this lovely untroubled look, and her family stopped saying, `Why are you angry? Why are you mad, Mom?' '' Carruthers said. ``She said, `Maybe we could use it to get rid of wrinkles?' and I said, `Good idea.'

``In fact, one of the concerns about Botox now - and it's one of the things you're pretty happy is a problem - is you could end up with a smooth brow surrounded by wrinkles.''

Growing sales

Allergan Inc., which has marketed Botox since 1990, reached about $90 million last year, up from $67 million in 1996 and $49 million in 1995. Spokeswoman Carolyn Henderson said the bulk of Botox still goes to treat eye and other medical disorders and that the amount used for cosmetic purposes ``would be a relatively small percentage.''

Dermatologists, however, say the Botox business couldn't be better - although the Food and Drug Administration has approved marketing the drug only to treat eye tics, known as blepharospasm, and crossed eyes, called strabismus. Although Allergan, based in Irvine, is forbidden from hawking Botox for cosmetic purposes, individual doctors are under no such restriction. The FDA does not know of any instances when the use of Botox for wrinkle removal has caused any serious complications such as death or permanent facial problems.

Noting that Botox injections are an office procedure, Donna Stein, spokeswoman for the American Academy of Dermatology in a Chicago suburb, said that no one tallies the number of annual treatments. Still, she said the procedure's popularity has exploded, especially in California, where scores of dermatologists now offer it.

``I've done thousands of patients; I do some every day,'' said Dr. Nicholas Lowe, a Santa Monica dermatologist who was involved in a study to determine how to get the maximum results from Botox with minimum side effects. ``We haven't seen any long-term side effects. The short-term problem, if you inject in the wrong location, can be a drooping eyelid. But even that's temporary.''

The treatment can also cause minor bruising, Luftman of Encino said.

Dr. Brian Mekelberg, a Los Angeles dermatologist, said Botox has several things to recommend it: The results are almost immediate, allowing for instant gratification and requiring only hours for the swelling to settle; new wrinkles do not form, because the powerful muscles that cause them are paralyzed; and an inability to squint, sometimes alleviating tension headaches.

``You can still laugh just as hard,'' said Donna Moore, 46, a dermatology nurse who relishes the results of Botox. ``You just don't crinkle as much. You're also more aware of frowning, so you just don't.''

Lowe, who is Moore's employer, said, ``Some people get Botox once and think, `Why am I bothering to do this? This is a waste of time and money, and I'll just live with my wrinkles.' That's a very healthy attitude, but it's not one a lot of people have.''

Daily News Staff Writer Betty Kwong contributed to this story

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5 Photos

Photo: (1--Cover--Color) END OF THE LINE

Botulism-based injection the hot new cure for wrinkles

Photo by David R. Crane, Photo Illustration by Bradford Mar/Daily News

(2--3) Sandy Goor of Calabasas, who began the treatments to get rid of the deepening crease in her brow, says she definitely notices a difference from before she started treatments, above.

(4) no caption (BOTOX)

(5) Dr. Debra Luftman, right, gives Goor an injection of Botox that will last anywhere from three to six months.

David R. Crane/Daily News