Glabellare Falten: Wie die Wirkung von Botulinumtoxin A verlängert werden kann

<b>Background:</b> Recently reported clinical data provides evidence that increasing the dose of botulinum toxin A increases the duration of efficacy. A 2-stage Phase 2, randomized, double-blind study investigated the duration of effect and safety of IncobotulinumtoxinA (INCO; Xeomin®, Bocouture®; Merz Pharmaceuticals GmbH, Frankfurt am Main, Germany) at doses higher than the approved 20 units (U) for glabellar frown lines (GFL). Primary safety and efficacy endpoints of Stage 1 are reported here. <b>Methods:</b> 151 subjects with moderate-to-severe GFL were randomized 1:2:2 to receive a single treatment with 20U, 50U, or 75U INCO. The primary efficacy endpoint was median duration of at least 1-point improvement from baseline as assessed by investigator at maximum frown on the Facial Wrinkle Scale. <b>Results:</b> The median duration of effect was 185 days for the 50U dose group (95% CI: [182, 205]) and 210 days for the 75U dose group (95% CI: [182, 217]). Duration of effect was significantly longer for 75U vs 50U (P = 0.0400) and 20U (P = 0.0166) despite the study not being powered for confirmatory statistical significance testing between the dose groups. Duration of effect was also longer for 50U vs 20U, however; statistical significance was not reached (P = 0.4349). The incidence of treatment-related adverse events was low across all doses (20U:2 [6.7%], 50U:6 [10.0%] and 75U:8 [13.1%]). <b>Conclusions:</b> These results demonstrate a dose effect of at least 6 months duration with higher doses in the majority of GFL subjects. All doses were well tolerated and safety was consistent with the known safety profile of 20U INCO for GFL. J Drugs Dermatol. 2020;19(10):985–991. doi:10.36849/JDD.2020.5454

Facial Expression Wrinkles and Their Relaxation by a Synthetic Peptide

Expression wrinkles form over time due to repeated facial movements such as smiling and frowning. They have an imprint on facial skin in areas such as the corner of the eyes, where they take the form of crow’s feet, the forehead and the glabella, where they appear as frown lines, and around the mouth, as marionette lines. In the study presented here, we recruited two sets of volunteers. An older group of 57 volunteers aged 50 to 65 years, and a group of eight younger volunteers aged 21–35 who were the biological daughters of eight of the older volunteers. Using VISIA CR, we took images of the volunteers in relaxed, angry and smiling mode to assess similarities in expression wrinkle patterns. In addition, the older volunteers were split into a placebo group and an active group who applied a formulation of 4% of a cosmetic product containing the peptide diaminobutyroyl benzylamide diacetate (DABBA) for four weeks. Wrinkles were assessed by image analysis, expert grading and Primoslite measurements. Our study found striking similarities in the facial wrinkle patterns of mothers with relaxed faces and daughters with angry or smiling faces. We found a decrease in visible wrinkles in the group of older volunteers applying DABBA. We created a facial map for graded wrinkles showing these changes. Volunteers using the active formulation showed significantly less wrinkle area and length on the forehead when frowning compared to the placebo group (p < 0.05).

The correlation between severity of melasma with facial wrinkles in Yogyakarta, Indonesia

Melasma is a common disfiguring condition involving acquired hyperpigmentation especially on the face, for which the pathogenesis is still uncertain, however histopathological studies showed that there is not only hyperpigmentation in the epidermis, but also solar elastosis or photo-aging due to abnormality of dermal extracellular matrix which contributes to clinical wrinkles. This study aimed to examine a link between the severity of melasma and facial wrinkles as a manifestation of photoaging in a tropical area. This study was an observational study with crosssectional design, conducted in Yogyakarta, Indonesia involving 51 patients with melasma aged 30-50 years who had fulfilled the inclusion and exclusion criteria. The melasma severity was measured clinically with the modified Melasma Severity Index (mMASI), and objectively with the Melanin Index (MI) and Erythema Index (EI) assessed with Mexameter Courage Khazaka. The wrinkle severity was measured clinically by scoring from forehead horizontal lines, crow’s feet, glabellar and nasolabial lines, and total scores were obtained from all of them. The correlation analysis was done statistically with Spearman’s rank tests. The results showed a weak positive but not significant correlation between the mMASI score and total facial wrinkle score (r: 0.165), and a weak positive non-significant correlation between EI and total facial wrinkle score (r: 0.06). There were significant positive moderate correlations between MI and total facial wrinkle score (r: 0.441), due to significant positive moderate correlations between MI and glabella wrinkle (r: 0.392), and between MI and nasolabial wrinkle (r: 0.339). In conclusion, a positive moderate correlation was found between MI and total facial wrinkle score, especially relating to glabellar and nasolabial wrinkles. However, there was no correlation between mMASI score and total facial wrinkle score.

Evaluation of Automatic Facial Wrinkle Detection Algorithms

Facial wrinkles (considered to be natural features) appear as people get older. Wrinkle detection is an important aspect of applications that depend on facial skin changes, such as face age estimation and soft biometrics. While existing wrinkle detection algorithms focus on forehead horizontal lines, it is necessary to develop new methods to detect all wrinkles (vertical and horizontal) on whole face. Therefore, we evaluated the performance of wrinkle detection algorithms on the whole face and proposed an enhancement technique to improve the performance. More specifically, we used 45 images of the Face Recognition Technology dataset (FERET) and 25 images of the Sudanese dataset. For ground truth annotations, the selected images were manually annotated by the researcher. The experiments showed that the method with enhancement performed better at detecting facial wrinkles when compared to the state-of-the-art methods. When evaluated on FERET, the average Jaccard similarity indices were 56.17%, 31.69% and 15.87% for the enhancement method, Hybrid Hessian Filter and Gabor Filter, respectively.

Application of botulinum toxin in maxillofacial field: Part III. Ancillary treatment for maxillofacial surgery and summary

Botulinum toxin (BTX) has various therapeutic indications: bruxism, square jaw, facial wrinkle, oral ulcer and maxillofacial pain, etc. In this paper, we will discuss the effectiveness of using BTX in dental implant surgery and orthognathic and orthodontic treatment. We summarized the clinical application of botulinum toxin in the maxillofacial field at the finale.

Application of botulinum toxin in maxillofacial field: Part II. Wrinkle, intraoral ulcer, and cranio-maxillofacial pain

Botulinum toxin (BTX) is used in various ways such as temporarily resolving muscular problems in musculoskeletal temporomandibular disorders, inducing a decrease in bruxism through a change in muscular patterns in a patient’s bruxism, and solving problems in patients with tension headache. And also, BTX is widely used in cosmetic applications for the treatment of facial wrinkles after local injection, but conditions such as temporomandibular joint disorders, headache, and neuropathic facial pain could be treated with this drug. In this report, we will discuss the clinical use of BTX for facial wrinkle, intraoral ulcer, and cranio-maxillofacial pain with previous studies and share our case.