Myobloc for facial wrinkles

Abstract

During the past decade, the injection of neuromuscular blocking agents produced by the anaerobic spore-forming bacterium Clostridium botulinum exotoxin has become one of the most popular therapeutic options for reducing or eliminating facial wrinkles, especially those in the glabellar area, forehead, and lateral orbital regions (crow’s feet). In December of 2000, the Food and Drug Administration approved the use of Botulinum toxin type B (BoNT-B; Myobloc) in the United States for the treatment of cervical dystonia. Off-label use of BoNT-B also has occurred subsequent to Food and Drug Administration approval, with facial wrinkles as the typical indication. There is a dearth of research in the literature assessing the efficacy and safety of BoNT-B for this purpose but, like Botulinum toxin type A (BoNT-A; Botox), local intradermal injection of BoNT-B appears to enhance dynamic facial wrinkles by inducing chemical dernervation of striated muscle, leading to temporary flaccid paralysis. This article reviews a pilot study involving the use of Botulinum type B for the treatment of facial wrinkles. The efficacy, safety, and duration of Myobloc is discussed.