The use of botulinum toxin‐A in the management of neck and anterior chest wall flushing: pilot study

Abstract

Idiopathic neck and chest wall flushing could cause disabling effects on patients' quality of life. We aimed to evaluate the effectiveness of botulinum toxin-A (BTA) in the management of idiopathic neck and chest wall flushing. This was a pilot prospective clinical study of patients with severe idiopathic neck and anterior chest wall flushing. Two mouse units of BTA were injected intracutaneously with a maximum dose of 100 units per patient per session. The dermatology life quality index is used as the primary outcome measure. Twenty-two patients were included in the study (18 women, four men) with an average age of 26 years (range 18-48). Twenty patients (90.9%) had immediate improvement with almost complete resolution of their flushing. At four weeks follow-up, 18 of 22 patients were included in the final analysis, significant improvement in quality of life was achieved, and mean baseline dermatology life quality index score 7.78 (SD 3.25) improved significantly to 4.23 (SD 3.44) with a mean difference of 3.56 (SD 4.6; 95%, confidence interval 1.27, 5.84) with paired samples t-test 3.29 (d.f. 17) P < 0.004. BTA may provide an effective treatment in the management of idiopathic neck and chest wall flushing.

Botulinum Toxin in the Field of Dermatology: Novel Indications

“…A number of reports demonstrate the possible action of BTX on rosacea and menopausal hot flashes [ 23 , 24 , 25 , 26 ] ( Table 3 ). In a prospective pilot study [ 23 ], the effect of BTX on the Dermatology Life Quality Index (DLQI) of patients with facial flushing was examined.…”

Facial Blanching: An Unusual Side Effect after Botulinum Toxin Injection

“…[2][3][4] However, BTX has been used for treatment of conditions related to vasodilation and flushing for quite a long time. Numerous articles have been published confirming its efficacy for treatment of the Frey's syndrome, 5 rosacea, 6 menopausal 7 and heat stress [8][9][10] flushings and Harlequin syndrome. 11 The mechanism of BTX action on the vascular tone has not been fully understood.…”

“…More recent prospective study, which enrolled 18 female and 4 male subjects, aged 18 to 48 years with severe idiopathic neck and anterior chest wall flushing confirmed that intradermal injections of BTX were effective and safe therapy for facial flushing. 10 This conclusion was made based on comparison of the DLQI (Dermatology Quality of life Index questionnaire) parameters assessed before and after treatment. Other similar in design study that enrolled 24 female subjects aged 18 to 60 years with facial flushing also confirmed the efficacy of BTX use in elimination of flushing symptoms.…”

The Efficacy and Safety of Fractional CO2Laser Combined with Topical Type A Botulinum Toxin for Facial Rejuvenation: A Randomized Controlled Split-Face Study

“…Regarding erythema and melanin index, there are no significant differences between BTX-A side and saline solution control side up to 12 weeks after laser treatment in all subjects. Several reports demonstrated that BTX-A can be used for the treatment of facial erythema and flushing [ 13 – 15 ]. The clinical results were substantiated with corresponding decreases in cutaneous blood flow, as measured using laser Doppler flowmetry [ 16 ].…”