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Botulinum B treatment of the glabellar and frontalis regions: a dose response analysis
James M Spencer1, Marsha Gordon, David J Goldberg
1Department of Dermatology of Mt. Sinai School of Medicine, New York, NY, USA.
Background:
Botulinum toxin injections represent the most commonly performed cosmetic procedure in the US. There is an enormous reported experience documenting the efficacy of botulinum toxin A injections. There is very limited published information about the efficacy and appropriate dosage of botulinum toxin B injections.
Objective:
The aim of this study was to evaluate the dosage response and side effect profile of botulinum toxin B injections.
Method:
Twenty-six subjects received botulinum B injections to their glabellar area. Eighteen subjects received botulinum B injections to their frontalis region. Three different dosages were used. In the glabellar treated subjects the low dose group received a total of 1875 units; the medium dose group received a total of 2500 units; and the high dose group received a total of 3125 units. In the frontalis treated group, the low dose group received a total of 2250 units; the medium dose group received a total of 3000 units; and the high dose group received a total of 3750 units of botulium B toxin.
Results:
In the glabellar group, most subjects showed some evidence of paralysis at 2 months. Only in the high dose group did a significant cadre of treated subjects still show a significant response at 3 months after treatment. In the frontalis group, response was often still seen at 2 months. However, at 3 months most subjects showed no continued effect from botulinum B toxin.
Conclusion:
Botulinum B toxin injections represent an alternative to botulinum A treatment for glabellar and frontalis hyperkinetic wrinkles. At the doses utilized in this study, the effect does not generally appear to last as long as has been reported with botulinum A injections. However, the onset of action may be sooner with botulinum B injections.