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Botox: Dermatologic Use Goes Beyond Cosmetic

The utility of Botulinum neurotoxin (BoNT or Botox) for cosmetic dermatology and for non-dermatological indications, such as treatment of myofascial pain syndromes and headaches, is well established. Botox is also used for a host of non-cosmetic dermatological conditions where the treatment is able to either improve disease symptoms or treat the disease entirely.

A recent article systematically reviewed the many small studies showing promising results for the use of BoNT in a multitude of dermatological diseases, including (but not limited to) hyperhidrosis, Darier’s disease, Hailey–Hailey disease, pompholyx and hidradenitis suppurativa. The authors looked at studies that reported the use of two different forms of botulinum neurotoxin (BoNT-A And BoNT-B). The review found that while there are many case examples within each disease category they highlighted, there were few double-blinded randomized controlled trials. Further, trials involving larger numbers of patients that include comparisons of dosage of therapy and subtypes of BoNT are lacking.

Nonetheless, there was evidence that BoNT can be used to treat hyperhidrosis, pruritic dermatoses, acantholytic disorders, inflammatory dermatoses, scarring, and fissures and ulceration. For many of these conditions, the exact underlying mechanism of action remains largely unknown, despite evidence of treatment effectiveness. The authors conclude that larger, double-blinded randomized control trials that compare BoNT to established treatments are needed to cement the evidence base underlying the use of BoNT in dermatology beyond cosmetic uses.


Byline: Martha L. Sikes, MS, RPh, PA-C

Posted: January 23, 2017

Source: Wiley Online Library
Adapted from the original article.

[Image: Shutterstock]

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