Table 2.
Studies on the use of BoNT-A therapy in facial erythema and flushing.
| First Author [Ref.], year | Type of Study | n | BoNT Doses | Follow-Up | Results |
|---|---|---|---|---|---|
| Al-Niaimi F 2020 [67] |
Prospective | 20 | In a 5 ml dilution of 500 units using typically 20–50 units per cheek or onabotulinum (BotoxTM, Allergan, Irvine, CA, USA) at 2.5 mL dilution in 100 units with doses ranging from 10 to 20 units per cheek. | 3,9 months | All patients experienced improvement of erythema (documented by a 3D Antera camera) |
| Friedman 2019 [68] |
Retrospective | 16 | 100 U of abobotulinumtoxin after Tixel treament | 1,3,6 months | flushing and erythema improvement (photographic assessment) |
| Park, 2015 [65] | Case report | 2 | 3 U in chin and the eyebrow area were injected; after 1 week, 5 U in each cheek and 2 U in chin and the eyebrow area were additionally injected (patient 1) 40, 15 U in the first treatment and 5 U in the second treatment for each cheek (patient 2) |
1 week to 3 months | Good improvement (photographic assessment) |
| Bloom, 2015 [69] | Prospective | 25 | 15, 45 U of intradermal injections of abobotulinum toxin A into the nasal tip, nasal bridge, and nasal alae | 3 months | The treatment resulted in statistically significant improvement in erythema grade at 1, 2, and 3 months after treatment when compared with baseline (3-grade scale of erythema severity on photographic assessment) |
| Geddoa, 2013 [64] | Pilot prospective | 22 | 2 U per injection point with maximum dose of 100 U (neck and/or chest) | 4 weeks | Twenty patients (90.9%) reported immediate improvement, and the remaining 2 patients had a second treatment session to achieve similar responses; at 4 weeks follow-up significant improvement in quality of life was measured with DLQI score |
| Odo, 2011 [63] | RCT | 60 | 500 U abobotulinum toxin A, 6.2 U injection at each selected point in the skin (40 injection points of face, chest, neck, scalp); for the control group, saline solution was used at the same volume of 0.04 mL per injection point | 6 months | The symptoms were less severe than before treatment; in the control group, there was no significant difference in mean intensity of sweating or in the mean number of hot flashes |
| Oh, 2011 [70] | RCT | 15 | BoNT-B doses NA; one side of the face was treated with BoNT-B, the other side with saline | 8 weeks | Ineffective; mexameter demonstrated significant improvement of erythema at 8 weeks after injections on both sides; the BoNT-B injection side did not show a significant decrease in objective erythema, compared with the control side; subjective satisfaction did not differ between the treated side and the control side |
| Alexandroff, 2006 [61] | Case report | 2 | 10 U spaced/hemifacial 1 cm between injections | 6 weeks | No improvement was noted 6 weeks after treatment |
| Kranendonk 2005 [62] | Case report | 1 | 2 U in midcheek region | Not reported | Paralysis of the zygomaticus major; no improvement after 1 week |
| Yuraitis, 2004 [60] | Case report | 1 | A total of 10 U were distributed at 1-cm increments to each cheek in the areas of the most prominent erythema | 2 weeks | Marked improvement and high satisfaction |