Unmasking Botulinum Toxin Myths

• Published in: Dermatology Times 2024-09, Vol.45 (9), p.22-25
• Main Authors: Curry, Andy, Rosenfeld, Jennifer, Levin, Melissa Kanchanapoomi
• Format: Magazinearticle
• Language: English
• Subjects: Aesthetics; Bacteria; Botulinum toxin; Evidence-based medicine; Light; Manufacturers; Manufacturing; Marketing; Medical colleges; Proteins
• ISSN: 0196-6197; 2150-6523

Botulinum toxin treatments are among the most common approaches to address aesthetic concerns worldwide.1'2 Starting as a potent neurotoxin produced by the bacteria Clostridium botulinum, botulinum toxin is now used globally in clinical practice, providing a highly accessible and minimally invasive solution to undesirable conditions such as facial wrinkles.3~5 Currently there are many different botulinum toxin products globally available, with more coming at an accelerated pace Nearly all aspects of botulinum toxins have changed dramatically since the first product was approved for therapeutic use in 1989,6,7 due to factors such as new manufacturing technologies, advances in toxin science, increases in the number of conditions treated and amount of toxin injected, and a shift in the patient demographics receiving these products.8,9 As these changes have occurred, so have inaccurate marketing messages, misuse of toxin-related scientific testing data, incomplete analyses of published data, and a general unaware-ness among health care professionals administering the toxins of the scope and scale of toxin usage. [...]toxin manufacturers have, at times, misrepresented and falsely claimed scientific data in attempts to differentiate toxins and advance market share.10,11 Brief Description of BoNT-A Manufacturing The bacteria Clostridium botulinum produces botulinum toxin type A (BoNT-A).1 Manufacturing BoNT-A for injection involves extracting the BoNT-A from the Clostridium botulinum bacteria, resulting in a BoNT-A neurotoxin core of 150 kDa surrounded by 150 to 750 kDa of complex-ing proteins. [...]these methods are what the FDA requires to establish potency. In some cases, mismatched comparisons could suggest a particular toxin formulation has increased duration of efficacy compared to another. [...]it is critical for any discussion regarding clinical end point comparisons to be mindful of the measurements used and to utilize the same clinical end point.