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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.
AuthorsSamireh Said, Azin Meshkinpour, Alastair Carruthers, Jean Carruthers
JournalAmerican journal of clinical dermatology (Am J Clin Dermatol) Vol. 4 Issue 9 Pg. 609-16 ( 2003) ISSN: 1175-0561 [Print] New Zealand
PMID12926979 (Publication Type: Journal Article, Review)
Chemical References
  • Neuromuscular Agents
  • Botulinum Toxins, Type A
Topics
  • Botulinum Toxins, Type A (administration & dosage)
  • Dermatology
  • Eye
  • Forehead
  • Humans
  • Hyperhidrosis (drug therapy)
  • Mouth
  • Neuromuscular Agents (administration & dosage)
  • Randomized Controlled Trials as Topic
  • Skin Aging
  • Surgery, Plastic

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