Marin physician Alan Scott, pioneer behind Botox, dies at 89

It is a neurotoxin 100 times more deadly than cyanide and the cause of the food-borne illness known as botulism. During World War II and for some years after, the Department of Defense hoped to develop it as a chemical weapon. But it wasn’t until the 1970s that Alan Scott, an ophthalmologist, turned this toxin, Clostridium botulinum, into a pharmaceutical when he began to investigate it as a medical treatment for serious eye impairments.

But the procedure succeeded, and Dr. Scott would go on to refine one of the world’s deadliest poisons into a life-altering treatment — he called it Oculinum — for those with conditions like strabismus, a misalignment of the eyes. Dr. Scott and his colleagues had spent decades researching and producing what they called Oculinum. But because they had no patent, no pharmaceutical company would manufacture it, and Dr. Scott resorted to taking out a mortgage on his house and asking for small donations from doctors, who then used it in clinical trials.

In the decades that followed, the public’s appetite for it as a facial enhancement exploded. Movie directors began complaining that actors were losing their ability to frown or smile properly — “frozen face” became a trope of the tabloids. It was derided as a pernicious enabler of a youth-obsessed society, a practice best left to the stars of reality television.

Dr. Scott earned an undergraduate degree in medical sciences from UC Berkeley in 1953 and a medical degree from the University of California, San Francisco. He had a surgical internship and residency in neurosurgery at the University of Minnesota, followed by a residency in ophthalmology at Stanford University. He was a founding member of the Smith-Kettlewell Eye Research Institute in San Francisco and the institute’s senior scientist and co-director for over two decades.

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