title: Skin cooling before periocular botulinum toxin A injection.
abstract: OBJECTIVE
  To determine if skin cooling decreases the pain associated with periocular botulinum toxin A injections.
  
  
  METHODS
  In this prospective study, 14 patients given bilateral periocular injections for blepharospasm or wrinkle reduction were included. Prior to the injections, one side received a skin cooling agent and the other side served as the control. Relative pain scores were recorded to assess the effects of treatment.
  
  
  RESULTS
  The range of pain scores on the noncooled side was 3 to 10 (average, 6.5); scores for the cooled side ranged from 0.5 to 7 (average, 3.6), which represents a 45% reduction in pain score.
  
  
  CONCLUSIONS
  In most patients, skin cooling decreases the pain associated with periocular botulinum toxin A injection.
authors.affiliation: Department of Ophthalmology, University of Tennessee Health Science Center, Memphis, 38163, USA. jlinder@mail.eye.utmem.edu
authors.forename: James S
authors.initials: JS
authors.lastname: Linder
authors.forename: Brenda C
authors.initials: BC
authors.lastname: Edmonson
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Laquis
authors.forename: Richard D
authors.initials: RD
authors.lastname: Drewry
authors.forename: James C
authors.initials: JC
authors.lastname: Fleming
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001764:Blepharospasm / Q000188:drug therapy*; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage* / Q000627:therapeutic use; D003080:Cold Temperature; D005143:Eyelids / Q000187:drug effects; D005260:Female; D006801:Humans; D007267:Injections; D008875:Middle Aged; D009465:Neuromuscular Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D010146:Pain / Q000503:physiopathology / Q000517:prevention & control*; D010147:Pain Measurement; D011446:Prospective Studies; D015595:Skin Aging / Q000187:drug effects*
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A