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Botox without a needle? That’s what a specialty bio-pharmaceutical company in California is exploring with their product known as RT001, Botox in cream form, according to WCBS-TV in New York City.

Revance Therapeutics says that it will be two years before clinical trials of their product is complete. After that the FDA will decide whether to approve the drug, which is being tested for use on crow’s feet.

Some doctors worry about the safety of such a product. Dr. David Colbert, a New York City dermatologist, told WCBS-TV that he worries that a Botox lotion product would be so popular that black market versions would be sold online without oversight and that the potential muscle paralyzing effects could be dangerous.

“I think it’s a brilliant idea, but I’m more concerned about the welfare of people who would use it irresponsibly,” he says.

Early trials showed a moderate reduction in wrinkles patients’ eyes after using the product for about a month. The product is being tested on crow’s feet because the thin skin around the eyes is susceptible to bruising when injected with Botox.

Dr. Richard Glogau, a clinical professor of dermatology at the University of California, San Francisco, who is a primary investigator for the study, said after early trials that Revance needed to rework the formulation so the drug would stay where it was applied and not spread to other parts of the body.

Other doctors are beginning to weigh in with their thoughts on this potential new cosmetic product. Dr. Anthony Youn, a plastic surgeon in Michigan, writes on his website: “I think a huge application of this topical botulinum toxin is in sweat reduction. Could you imagine an antiperspirant stick with this product that lasts several months with each application and leaves no residue? I’d buy it!”

Watch the WCBS-TV segment at http://wcbstv.com/video by searching for “Botox cream.” (Pictured: before & after use of RT001 for 28 days; image via WCBS-TV)

Botox is famous for its ability to smooth wrinkles when injected into the face, but Johns Hopkins researchers may have found another use that goes beyond the cosmetic procedure.

Researchers discovered that patients with a painful and debilitating nerve compression disorder called thoracic outlet syndrome (TOS) reported a significant reduction in short-term pain after receiving a single, low-dose injection of Botox in a neck muscle.

The study suggests that Botox could be a minimially-invasive alternative to surgery to remove the first rib and sever one of the muscles in the neck—the syndrome’s treatment of last resort.

“There haven’t been many alternatives to the use of surgery to treat this syndrome,” says Paul J. Christo, M.D., M.B.A., an assistant professor of anesthesiology and critical care medicine at the Johns Hopkins University School of Medicine and the study’s lead author. “Botox seems to be an effective treatment that avoids surgery’s obvious drawbacks, such as its invasive nature and long recovery time.”

The effects of Botox in TOS patients begin to wear off in a few months, as they do when Botox is used to treat facial wrinkles. Dr. Christo says patients should be able to receive repeated injections of Botox into the muscle over time; however, some could develop antibodies to the compound with excessive use, which would mean the toxin would no longer block pain.

Even as more therapeutic uses for Botox are found, it remains a popular cosmetic procedure. Statistics from the American Society of Plastic Surgeons show it was the number one minimally-invasive cosmetic procedure performed in 2009 in the United States and is one of the procedures Dr. Heffernan performs in his Seattle office.

Read the full release on the study at  the Johns Hopkins Medicine website.