title: The convergence of medicine and neurotoxins: a focus on botulinum toxin type A and its application in aesthetic medicine--a global, evidence-based botulinum toxin consensus education initiative: part I: botulinum toxin in clinical and cosmetic practice.
abstract: BACKGROUND
  The U.S. Food and Drug Administration has approved four distinct formulations of botulinum toxin (BoNT) serotypes A and B (BoNTA and BoNTB) for medical use. These four products are indicated for many medical applications, but the three BoNTA formulations are the most widely used worldwide and are the only products approved for aesthetic use. The latest approval of a BoNTA with no complexing proteins (incobotulinumtoxinA) necessitates a review and discussion of differences between available formulations and the effect that these differences may have on clinical practice.
  
  
  OBJECTIVE
  To review the history, science, safety information, and current and emerging applications of BoNT in clinical and cosmetic practice and to compare commercially available BoNTA formulations.
  
  
  METHODS
  Publications, clinical trials, and author experience were used as a basis for an up-to-date review of BoNT and its use in human medicine. The similarities and differences between formulations are presented, and diffusion, spread, equivalency ratios, stability, and storage are discussed.
  
  
  RESULTS
  Each commercial formulation has unique characteristics that may influence its use in aesthetic medicine. Familiarity with the similarities and differences between products will aid physicians in making patient care decisions.
  
  
  CONCLUSIONS
  New formulations, emerging uses, and continued research into the science and uses of BoNTA will lead to increasingly refined therapeutic approaches and applications. Continued education is important for physicians to optimize use of the agent according to the most current evidence and approaches.
authors: Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada.
authors: Alastair
authors: A
authors: Carruthers
authors: Michael A C
authors: MA
authors: Kane
authors: Timothy C
authors: TC
authors: Flynn
authors: Peter
authors: P
authors: Huang
authors: Sang D
authors: SD
authors: Kim
authors: Nowell
authors: N
authors: Solish
authors: Gina
authors: G
authors: Kaeuper
mesh_terms: D001905:Botulinum Toxins / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use; D002626:Chemistry, Pharmaceutical; D003357:Cosmetic Techniques; D006801:Humans
chemical_list: D001905:Botulinum Toxins; D019274:Botulinum Toxins, Type A; C542869:abobotulinumtoxinA; C545476:incobotulinumtoxinA