A new serotype of
botulinum toxin has recently arrived in the US.
Botulinum toxin type B (
BTX-B), known as
Myobloc in the United States and as
Neurobloc in Europe, is one of seven different antigenic members of the
botulinum toxin family, five of which the human nervous system is susceptible to. Like
botulinum toxin type A (BTX-A),
BTX-B has been used for a myriad of both dermatologic and nondermatologic problems since its recent approval by the FDA for the treatment of
cervical dystonia in December 2000. It is currently not approved however, for a cosmetic use but has been used for this purpose in an "off-label" fashion. It has followed in the therapeutic footsteps of BTX-A in the prevention and treatment of facial wrinkles such as crow's feet and glabellar frown lines. In addition, one of its current and popular uses is in the management of
hyperhidrosis, a disease in search of a long needed treatment. This past year researchers have been investigating the efficacy as well as defining the dosing and application regiments of
BTX-B in the treatment of
hyperhidrosis. In addition, recent studies have been examining its side effect profile, which may be very different than that seen with BTX-A. There are only a handful of studies in the literature examining the cosmetic applications of
BTX-B. This chapter will review what is currently known about
BTX-B and its current use in regards to the treatment of
hyperhidrosis.