New Uses of AbobotulinumtoxinA in Aesthetics

Abstract

BotulinumtoxinA (BoNT-A) is now widely established for the main approved indication of reducing glabellar lines, and is also widely used off-label to improve the appearance of wrinkles and lines in other parts of the face. The number of aesthetic procedures continues to increase as the patient population becomes more diverse, in particular with increasing numbers of people of color and men. Further developments in treatment may continue to expand the audience for BoNT-A by making procedures more comfortable and by delivering a more natural, less static appearance. These may be achieved through use of combinations of BoNT-A with other aesthetic procedures, tailoring the dose of toxin to the patient’s muscle mass or by using novel injection and application techniques. Beyond amelioration of facial lines, encouraging results have been seen with the use of BoNT-A to improve the appearance of hypertrophic and keloid scars and even to prevent them. Studies have been conducted with scars in various parts of the body and further research is ongoing. Dermatological and other medical uses for BoNT-A are also active areas of research. Injections of BoNT-A have been shown to reduce signs and symptoms of acne, rosacea, and psoriasis, to reduce neuromuscular pain, and to bring about significant improvements in a number of rare diseases that are caused or exacerbated by hyperhidrosis. This paper reviews these new uses for BoNT-A, looking at the rationale for their use and discussing the results of published case studies and clinical trials. These areas have shown great promise to date, but more and larger clinical studies will be required before these treatments become a clinical reality. To this end details are also provided of clinical trials currently listed in the main clinical trials database to highlight research areas of particular interest.

Intradermal Micro-Dosing of AbobotulinumtoxinA for Face-Lifting: How Long Does It Last?

“…The main disadvantage of the intradermal BoNT/A injection technique for face-lifting is that physicians need to be trained on how to deliver the microdroplet injections both consistently and superficially to avoid inadvertently paralyzing the deeper muscle underlying the treated area [ 16 ].…”

Normal and keloid fibroblasts are differentially influenced by IFN‐γ and triamcinolone as well as by their combination

“…Normalizing the unbalanced proliferative behavior, the changed cytokine expression profile as well as reducing anabolic processes and inducing catabolic processes of extracellular matrix proteins are possible regulators to reduce the keloid recurrence rate . Intralesional injection of glucocorticoids—mostly TA—is one of the standard treatment regimens that was recently supplemented by the injection of botulinum toxin . In this context, interferons— respectively, IFN‐γ and IFN‐α—are promising candidates due to their well described influence on collagen expression and collagenase activity .…”

Botulinum toxin type A in chronic non‐dyshidrotic palmar eczema: A side‐by‐side comparative study

“…Acting on specific presynaptic nerve endings, BTX‐A prevents the release of the neurotransmitter acetyl choline 2 . In the skin, neuromuscular junctions of striated muscles and eccrine glands use cholinergic transmission; hence, the toxin has been beneficial in spastic conditions (including dynamic facial wrinkles) and localized hyperhidrosis 3 …”