Dr Kerryn Phelps, Health Editor, 'Today', Nine Network with Tracey Grimshaw

GRIMSHAW: Now, these warning signs about Botox - they make a bit of sense, don't they?

PHELPS: Well, they do. It's a very potent nerve toxin or neuro-toxin and the case that's been used as a poison and has been known as a poison for many, many years, but its use as a pharmacological agent, and very usefully so in medicine over the recent years has meant that there has to be a new examination of this very potent poison.

GRIMSHAW: How has it been considered 'okay' to just routinely, for purely aesthetic, cosmetic reasons, inject this neuro-toxin that causes paralysis to your face?

PHELPS: Well, they're using small doses in very targeted areas, and as the medical journal in Britain has pointed out - the BMJ - there are real concerns over the long-term possible effects of Botox, and the problem is that it hasn't actually been studied. So, if people are going and having these injections regularly, every few months, thinking that everything is just fine because it all wears off, we still don't know what effect that is likely to have on, for example, the sensory nerves - the nerves responsible for sensation. We know that it paralyses briefly, for several months, the motor nerves - the nerves responsible for movement, but we don't know what it does to the sensory nerves, particularly in the long-term and that's something that really needs to be explored.

GRIMSHAW: Do we know what happens to the Botox that is injected, once it wears off? Does that mean it's dissipated through the system, or does it mean that the body has defeated the toxin? What has happened to it?

PHELPS: I don't think anybody knows exactly what happens to it. But, certainly, it's in the body…

GRIMSHAW: …It's a bit scary, isn't it?

PHELPS: …and it's in the system, and the body deals with it in some way. I mean, there's become such complacency about it that there are pharmacy chains in Britain where you can go in in your lunchtime and somebody will inject you with the Botox, in your lunchtime and you know, charge you 200 pounds for the privilege.

GRIMSHAW: Alright. So, I guess the advice there is be weary.

PHELPS: I think it's really important to be weary, and I think there needs to be some research into the long-term effects of Botox. Very useful, for example, for stopping excess sweating under the arms. It's being used in painful muscle spasms, in ticks on the face, and not just for cosmetic reasons. So, there are some very useful aspects to Botox but, there are also just these warning signals that are coming through about what we don't know.

GRIMSHAW: Alright. Now, Zyban is causing problems, again.

PHELPS: Yes. Zyban was released with quite a flourish and was hailed as an answer for people who couldn't give up smoking any other way. It's a drug in the anti-depressant class. It's one that was found when used for depression was also very useful for helping people to quit smoking. Now, the reports that have come out are reports where people have used Zyban in overdose in an attempt to suicide or where children have accidentally got hold of Zyban tablets and taken them when they're lying around their parents home. And the problem that they're seeing in emergency departments is people with extreme aggression, who have been fitting, have seizures, convulsions, and who have heart problems related to that overdose. That being said, there are also some reports of side-effects, as you will get with any medication and, at the moment there are no plans to remove Zyban from the Pharmaceutical Benefits Scheme, but it's one to be taken as a note of caution to only take in the appropriate doses, to report any side-effects and not to keep them anywhere in the reach of children.

GRIMSHAW: If there are people at home who are watching, who are on Zyban, and wondering whether or not they're sort of borderline for being at risk in their use, what should they look for, in themselves?

PHELPS: They should read the consumer medicine leaflet that comes with the medication. They should talk to their doctor or their pharmacist if they've got any hint of side-effects and just discuss those, discuss their personal possibility of any side-effects, make sure that they're on the right dose and obviously, as soon as they feel that they're able to stay off the cigarettes then they should talk about coming off the medication.

GRIMSHAW: Alright. Now, skin cancer. We're about into summer - it feels like we're already into it. It's going to be a boiler. Are we getting the message?

PHELPS: Well, yes and no. A lot of people are not getting the message and it would appear that young girls, teenagers - we've had some cases reported of melanomas in under 15's, which is disastrous, obviously. And the rates for men are worrying, in terms of melanoma, which is a potentially fatal skin cancer and it looks as though, while there was a dip in the numbers of men getting melanomas around about the late 90's, that that's started to rise again. And it seems that people who aren't getting the message are these younger girls and men, particularly men who are outdoor workers, who are at work with their shirts off, they don't put shirts on, they don't put sunscreen on and they're at risk. And, there's in fact been a doubling of melanoma rates in men since 1983, all up. So, the 'Slip, Slop, Slap' campaign needs to continue, people need to take it seriously - it's not a joke, it's not something that's just a fancy slogan - it's something that can save your life. Skin cancers are one of the most common cancers and they can kill, and sun is one of the greatest risk factors.

GRIMSHAW: Okay. Thanks, Kerryn.

PHELPS: Thanks, Tracey.

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