Alastair Carruthers: dermatologist who pioneered cosmetic use of Botox in partnership with ophthalmologist wife Jean

Abstract

Jean Carruthers, an ophthalmologist, came home from work one evening and told her dermatologist husband Alastair about a conversation she had had with a patient. As part of a clinical trial1 she was using botulinum toxin to treat patients with dystonia, an involuntary spasm of the eyelids. One of her patients had asked to be treated between her eyes. When Jean told the patient that she had not thought she was spasming there, the patient replied that she was not, but every time Jean injected her there, her frown lines disappeared. Alastair was intrigued and the couple, working in private practice in Canada, decided to see if botulinum toxin had the same effect on others. Their receptionist, Cathy Bickerton Swann, then aged 30, had deep frown lines and agreed to the experiment. Carruthers administered the injections and in a few days they had almost disappeared. The couple’s first peer reviewed study of frown lines—the glabellar lines—involved 18 patients. Before they started, Carruthers injected his wife, at her request, to show that the procedure was safe. “I haven’t frowned since 1987,” …