Revival of the use of botulinum toxin: application in dermatology

Botulinum toxins (BTXs) comprise a family of neurotoxins designated as types A-G, which are produced by the anerobic bacterium Clostridium botulinum. BTX-A blocks the cholinergic transmission resulting in flaccid paralysis and autonomous nerve dysfunction. It has become a powerful therapeutic tool in a variety of conditions over the last decades. Primarily used in the treatment of strabismus, blepharospasm and hemifacial spasms, BTX has only recently been recognized in dermatology. The use of BTX in dermatology includes the treatment of focal hyperhidrosis, hyperfunctional facial lines as well as paralysis of the anal sphincter in the therapy of anal fissures. The mechanism of action is described and the current literature is reviewed.