Topical Botulinum Toxin for Crow's Feet Wrinkles

Murad Alam, MD, MSCI reviewing Mahmoud BH et al. Dermatol Surg 2015 Jan.

A randomized, controlled trial demonstrated a proof of concept that topical botulinum toxin can be effective when applied to periorbital skin that has been exposed to ablative fractional CO2 laser treatment.

The usual delivery of botulinum toxin for correction of wrinkles is via injection. Some patients may have concerns about pain or bruising to the crow's feet area. Topical botulinum toxin A has not been effective for wrinkling in this area. To determine whether laser treatment might improve effectiveness, Mahmoud and colleagues studied the effects of topical botulinum toxin applied to the skin of the lateral canthal area immediately after ablative resurfacing with a fractional carbon dioxide laser.

In this randomized, controlled trial, each of 10 patients received toxin and laser to the periorbital wrinkles on one side and saline vehicle and laser to the contralateral side. Rating improvement on the 5-point Crow's Feet Grading Scale, a clinically and statistically significant improvement was noted at 1 month compared to baseline on the treated sides but not on the control sides.

CITATION(S):

Mahmoud BH et al. Prospective randomized controlled study to determine the effect of topical application of botulinum toxin A for crow's feet after treatment with ablative fractional CO2 laser. Dermatol Surg 2015 Jan; 41:Suppl 1:S75-81.