Dr. Peter Velthuis-Non-cosmetic indications and treatment strategies with botulinum toxin in dermatology

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There are a lot of indications of non-cosmetic use of botulinum neurotoxins in dermatology like:

  • Blistering diseases
  • Disorders of cutaneous pigmentation
  • Disorders of cutaneous vasculature
  • Eczematous diseases
  • Genodermatoses
  • Hair disorders
  • Mucocutaneous viral infections

Toxin can help us to deal with scat formation. It reduces muscle tension and modules fibroblast activity. Studies showed that botulinum toxin improves facial surgical scars. It can also be used for treatment of primary hyperhidrosis.

Hyperhidrosis recommendations:

Dosage:

  • Axillary 50 units per side
  • Palmar 75-100 units per hand
  • Plantar 100-200 units per hand

Way to administer:

  • 1-2 cm apart
  • Injection angle 30-45°

Level of injection:

  • Dermo-subcutaneous junction

As a pilot to randomized, double-blinded, placebo-controlled trial, botulinum toxin effect in the treatment of Raynaud’s phenomenon was studied. Two patients were treated and responded excellently to infiltration with botulinum toxin:

  • Decrease in VAS (pain, stiffness, numbness) scores
  • Significant increase in superficial skin blood

We will review results of this and other studies about treating Raynaud’s phenomenon with botulinum toxin.