Injectable and topical neurotoxins in dermatology: Basic science, anatomy, and therapeutic agents

J Am Acad Dermatol. 2017 Jun;76(6):1013-1024. doi: 10.1016/j.jaad.2016.11.022.

Abstract

Botulinum toxin is a potentially deadly anaerobic bacterial toxin that acts by inhibiting release of acetylcholine at the neuromuscular junction, thereby inhibiting contraction of the exposed striated muscle. There are currently 4 botulinum toxin preparations approved by the US Food and Drug Administration (FDA): onabotulinumtoxin, abobotulinumtoxin, incobotulinumtoxin and rimabotulinumtoxin. While significant overlap exists, each product has unique properties and specifications, including dosing, diffusion, and storage. Extensive physician knowledge of facial anatomy, coupled with key differences of the various neurotoxin types, is essential for safe and successful treatments. The first article in this continuing medical education series reviews key characteristics of each neurotoxin, including new and upcoming agents, and provides an anatomic overview of the most commonly injected cosmetic sites.

Keywords: Clostridium botulinum; RT001; RT002; abobotulinum; anatomy; botulinum toxin; incobotulinum; lower face; neuromodulator; neurotoxin; new indications; onabotulinum; properties; rimabotulinum; upper face.

Publication types

  • Review

MeSH terms

  • Administration, Topical
  • Botulinum Toxins / administration & dosage*
  • Botulinum Toxins / therapeutic use
  • Cosmetic Techniques
  • Dermatology / methods
  • Facial Muscles / anatomy & histology
  • Humans
  • Injections
  • Neurotoxins / administration & dosage*
  • Neurotoxins / therapeutic use

Substances

  • Neurotoxins
  • Botulinum Toxins