Successful use of Botulinum toxin-A for the treatment of neck and anterior chest wall flushing

Abstract

Neck and anterior chest wall flushing can be a social handicap to the sufferer and current treatment options are often unsatisfactory. We report the case of a 48-year-old woman with severe flushing of the anterior neck and anterior chest wall which resolved after three treatments of intracutaneous botulinum toxin A injections. We believe that this treatment method for skin flushing is simple, effective and free of significant side effects at these sites. Further studies are needed to evaluate the duration of the therapeutic effect.

Symptomatic treatment of idiopathic and rosacea-associated cutaneous flushing with propranolol

“…1,3,4 Single case reports exist for improvement of resistant flushing with thoracoscopic sympathectomy 6 and injection of botulinum toxin A. 7,8 Biofeedback training also failed to show objectively measured decreases in flushing. 9 Cutaneous flushing is frequently associated with anxiety reactions.…”

Facial flushing associated with duloxetine use

“…Botulinum toxin type A was not likely to cause this adverse event, as this agent has been used to treat flushing. 4,5 Pindolol was not likely to be the cause of the flushing, since the patient had been taking the drug for many years and continued to take it after the flushing subsided after discontinuation of duloxetine.…”

Botulinum Toxin Off-Label Use in Dermatology: A Review

“…After some exciting case reports [77,78] and equally discouraging results [79,80,81] , in 2011 Odo et al [82] realized a numerous enrollment of 60 women affected by menopausal hot flushing and treated the affected area (scalp, face, neck, and chest) with a total of 500 U of abobotulinum toxin A, diluted in 3.2 mL of saline solution, and applied intradermally as a 6.2-U injection at each selected point in the skin. For the control group, saline solution was used at the same volume of 0.04 mL per injection point.…”