Botulinum Toxins in Medical and Cosmetic Dermatology

Background: Botulinum toxin (BoNT), a bacterially produced neurotoxin, is a mainstay in the dermatologic armamentarium. Although BoNT is commonly used to treated rhytides associated with ageing, it can be employed for a variety of other cosmetic purposes and medical disorders. Objective: In this review, the authors aim to describe the multitude of uses for BoNT in the dermatologic field. Materials and Methods: This manuscript was designed as a retrospective review of the on- and off-label applications of BoNT in dermatology.Results: In addition to treatment of rhytides, BoNT has been shown to decrease rosacea, menopause-associated flushing, and facial sebum production, while improving patient confidence in their appearance. Furthermore, BoNT has been successfully used to treat primary hyperhidrosis, hair loss, aberrant scarring, Raynaud’s phenomenon-associated vasospasm, as well as a variety of skin diseases. Side effects of BoNT include pain or discomfort associated with injections during treatment, bruising, asymmetry, and swelling. Patients are generally satisfied with clinical results after BoNT treatment. Conclusion: Dermatologists should be aware of all on- and off-label applications of BoNT to provide patients with timely and appropriate medical care. Further research must be completed to fully characterise the safety and use of BoNT for off-label purposes.

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FDA Approvals and Consensus Guidelines for Botulinum Toxins in the Treatment of Dystonia

Toxins ◽

10.3390/toxins12050332 ◽

2020 ◽

Vol 12 (5) ◽

pp. 332 ◽

Cited By ~ 2

Author(s):

Lauren L. Spiegel ◽

Jill L. Ostrem ◽

Ian O. Bledsoe

Keyword(s):

Botulinum Toxin ◽

Literature Review ◽

American Academy ◽

Practice Guidelines ◽

European Federation ◽

Botulinum Toxins ◽

Consensus Guidelines ◽

Off Label ◽

Fda Approval ◽

American Academy Of Neurology

In 2016, the American Academy of Neurology (AAN) published practice guidelines for botulinum toxin (BoNT) in the treatment of blepharospasm, cervical dystonia, adult spasticity, and headache. This article, focusing on dystonia, provides context for these guidelines through literature review. Studies that led to Food and Drug Administration (FDA) approval of each toxin for dystonia indications are reviewed, in addition to several studies highlighted by the AAN guidelines. The AAN guidelines for the use of BoNT in dystonia are compared with those of the European Federation of the Neurological Societies (EFNS), and common off-label uses for BoNT in dystonia are discussed. Toxins not currently FDA-approved for the treatment of dystonia are additionally reviewed. In the future, additional toxins may become FDA-approved for the treatment of dystonia given expanding research in this area.

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Therapeutic Use of Botulinum Neurotoxins in Dermatology: Systematic Review

Toxins ◽

10.3390/toxins13020120 ◽

2021 ◽

Vol 13 (2) ◽

pp. 120

Author(s):

Emanuela Martina ◽

Federico Diotallevi ◽

Giulia Radi ◽

Anna Campanati ◽

Annamaria Offidani

Keyword(s):

Systematic Review ◽

Skin Diseases ◽

Meta Analysis ◽

Published Data ◽

Efficacy And Safety ◽

Botulinum Toxins ◽

Epidermolysis Bullosa Simplex ◽

Off Label ◽

Facial Erythema ◽

Notalgia Paresthetica

Botulinum toxin is a superfamily of neurotoxins produced by the bacterium Clostridium Botulinum with well-established efficacy and safety profile in focal idiopathic hyperhidrosis. Recently, botulinum toxins have also been used in many other skin diseases, in off label regimen. The objective of this manuscript is to review and analyze the main therapeutic applications of botulinum toxins in skin diseases. A systematic review of the published data was conducted, following Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Botulinum toxins present several label and off-label indications of interest for dermatologists. The best-reported evidence concerns focal idiopathic hyperhidrosis, Raynaud phenomenon, suppurative hidradenitis, Hailey–Hailey disease, epidermolysis bullosa simplex Weber–Cockayne type, Darier’s disease, pachyonychia congenita, aquagenic keratoderma, alopecia, psoriasis, notalgia paresthetica, facial erythema and flushing, and oily skin. Further clinical trials are still needed to better understand the real efficacy and safety of these applications and to standardize injection and doses protocols for off label applications.

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Electrical Stimulation of Injected Muscles to Boost Botulinum Toxin Effect on Spasticity: Rationale, Systematic Review and State of the Art

Toxins ◽

10.3390/toxins13050303 ◽

2021 ◽

Vol 13 (5) ◽

pp. 303

Author(s):

Alessandro Picelli ◽

Mirko Filippetti ◽

Giorgio Sandrini ◽

Cristina Tassorelli ◽

Roberto De Icco ◽

...

Keyword(s):

Systematic Review ◽

Electrical Stimulation ◽

Botulinum Toxin ◽

Current Literature ◽

Electric Stimulation ◽

Botulinum Toxin Type A ◽

Type A ◽

Botulinum Toxin Type ◽

Botulinum Toxins ◽

Stimulation Of

Botulinum toxin type A (BoNT-A) represents a first-line treatment for spasticity, a common disabling consequence of many neurological diseases. Electrical stimulation of motor nerve endings has been reported to boost the effect of BoNT-A. To date, a wide range of stimulation protocols has been proposed in the literature. We conducted a systematic review of current literature on the protocols of electrical stimulation to boost the effect of BoNT-A injection in patients with spasticity. A systematic search using the MeSH terms “electric stimulation”, “muscle spasticity” and “botulinum toxins” and strings “electric stimulation [mh] OR electrical stimulation AND muscle spasticity [mh] OR spasticity AND botulinum toxins [mh] OR botulinum toxin type A” was conducted on PubMed, Scopus, PEDro and Cochrane library electronic databases. Full-text articles written in English and published from database inception to March 2021 were included. Data on patient characteristics, electrical stimulation protocols and outcome measures were collected. This systematic review provides a complete overview of current literature on the role of electrical stimulation to boost the effect of BoNT-A injection for spasticity, together with a critical discussion on its rationale based on the neurobiology of BoNT-A uptake.

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Botulinum toxin complications in registered and off‐label aesthetic indications

Journal of Cosmetic Dermatology ◽

10.1111/jocd.13667 ◽

2020 ◽

Vol 19 (10) ◽

pp. 2484-2490

Author(s):

Marina Landau ◽

Mark S. Nestor ◽

Ada Trindade Almeida ◽

Firas Al‐Niaimi

Keyword(s):

Botulinum Toxin ◽

Off Label

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A preliminary study of painless and effective transdermal botulinum toxin A delivery by jet nebulization for treatment of primary hyperhidrosis

Drug Design Development and Therapy ◽

10.2147/dddt.s60389 ◽

2014 ◽

pp. 931 ◽

Cited By ~ 8

Author(s):

Tommaso Iannitti ◽

Alessandro Di Cerbo ◽

Anna Aspiro ◽

Beniamino Palmieri

Keyword(s):

Botulinum Toxin ◽

Botulinum Toxin A ◽

Toxin A ◽

Primary Hyperhidrosis ◽

Preliminary Study

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Procedures in Cosmetic Dermatology: Botulinum Toxin.

Ophthalmic Plastic and Reconstructive Surgery ◽

10.1097/00002341-200603000-00029 ◽

2006 ◽

Vol 22 (2) ◽

pp. 154-155

Author(s):

Tamara R. Fountain

Keyword(s):

Botulinum Toxin ◽

Cosmetic Dermatology

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Clinical use of non-a botulinum toxins: Botulinum toxin type C and botulinum toxin type F

Neurotoxicity Research ◽

10.1007/bf03033930 ◽

2006 ◽

Vol 9 (2-3) ◽

pp. 127-131 ◽

Cited By ~ 37

Author(s):

Roberto Eleopra ◽

Valeria Tugnoli ◽

Rocco Quatrale ◽

Ornella Rossetto ◽

Cesare Montecucco ◽

...

Keyword(s):

Botulinum Toxin ◽

Botulinum Toxin Type ◽

Clinical Use ◽

Botulinum Toxins ◽

Type C

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Neurotoxins

Facial Plastic Surgery ◽

10.1055/s-0039-1688844 ◽

2019 ◽

Vol 35 (03) ◽

pp. 230-238

Author(s):

Adrian A. Ong ◽

David A. Sherris

Keyword(s):

Botulinum Toxin ◽

Clinical Applications ◽

Facial Nerve Paralysis ◽

Hypertrophic Scars ◽

Nerve Paralysis ◽

Facial Plastic Surgery ◽

Off Label ◽

Brow Ptosis ◽

Facial Plastic ◽

The Aesthetic

AbstractBotulinum toxin is integral to the practice of facial plastic surgery. Since it was approved by the U.S. Food and Drug Administration for the temporary improvement of glabellar rhytids in 2002, botulinum toxin has achieved a growing number of off-label clinical applications. These include the management of facial rhytids, brow ptosis, excessive gingival display, masseteric hypertrophy, platysmal banding, facial nerve paralysis, hypertrophic scars, and keloids. Many forms of botulinum toxin have been developed, and their safety and efficacy have been thoroughly established. This article will review the aesthetic and functional uses of botulinum toxin as it relates to the field of facial plastic and reconstructive surgery. In addition, the authors will discuss the suggested quantity of units per injection site based on onabotulinumtoxinA.

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Botulinum Toxin Use in the Lower Urinary Tract

The Scientific World JOURNAL ◽

10.1100/tsw.2007.150 ◽

2007 ◽

Vol 7 ◽

pp. 808-817

Author(s):

Shelby N. Morrisroe ◽

Michael B. Chancellor

Keyword(s):

Botulinum Toxin ◽

Urinary Tract ◽

Overactive Bladder ◽

Lower Urinary Tract ◽

Botulinum Neurotoxin ◽

Botulinum Toxins ◽

Muscle Paralysis ◽

Botulinum Neurotoxin A ◽

Beneficial Effects ◽

Lower Urinary

Botulinum toxins are well known for their ability to disrupt neurotransmission and cause muscle paralysis. Recently, urologists have discovered their beneficial effects in patients with neurogenic and overactive bladder conditions. This review is intended to provide a quick overview for urologists of the structure, function, and clinical uses of botulinum neurotoxin A in the lower urinary tract.

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