title: Botulinum toxin A: its expanding role in dermatology and esthetics.
abstract: The use of botulinum toxin A in cosmetic dermatology has increased in popularity due to the efficacy and relative safety of the treatment. Botulinum toxin A is one of eight exotoxins produced by Clostridium botulinum, a Gram-positive, spore-forming anaerobe. Flaccid paralysis results from the denervation of muscle fibers at the neuromuscular junction after botulinum toxin A administration. While treating blepharospasm, the Carruthers incidentally found that botulinum toxin A improved glabellar frown lines. Dynamic rhytides occur in areas of dynamic motion. These types of lines may be improved with botulinum toxin A. There are two types of botulinum toxin A commercially available (BOTOX and Dysport); only BOTOX is currently available in the US. The efficacy and tolerability of BOTOX was best demonstrated with a multicenter, double-blind, randomized, placebo-controlled study of the efficacy and safety of botulinum toxin type A in the treatment of glabellar lines in 264 patients. There was a significantly greater reduction in glabellar line severity with BOTOX. The effect was maintained for the duration of the study (120 days). There was low occurrence (5.4%) of mostly mild blepharoptosis in the BOTOX group. In another prospective study, it was found that about 1% of BOTOX patients reported severe headache. Botulinum toxin A can provide an alternative treatment of palmar and axillary hyperhidrosis when options such as topical agents (aluminum chloride) and iontophoresis have failed.
authors.affiliation: University of California, Irvine, California, USA. samirehsaid@hotmail.com
authors.forename: Samireh
authors.initials: S
authors.lastname: Said
authors.forename: Azin
authors.initials: A
authors.lastname: Meshkinpour
authors.forename: Alastair
authors.initials: A
authors.lastname: Carruthers
authors.forename: Jean
authors.initials: J
authors.lastname: Carruthers
mesh_terms: D019274:Botulinum Toxins, Type A / Q000008:administration & dosage*; D003880:Dermatology; D005123:Eye; D005546:Forehead; D006801:Humans; D006945:Hyperhidrosis / Q000188:drug therapy*; D009055:Mouth; D009465:Neuromuscular Agents / Q000008:administration & dosage*; D016032:Randomized Controlled Trials as Topic; D015595:Skin Aging; D013518:Surgery, Plastic
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A