Aesthetic Uses of Botulinum Toxins

Abstract Botulinum neurotoxins have proven efficacy for a variety of clinical conditions resulting from neuromuscular hyperactivity, which includes spasticity and blepharospasm. The approved aesthetic and dermatological indications for type A botulinum toxins include treatment of hyperfunctional facial muscles causing facial lines and the treatment of focal hyperhidrosis. In 1992, botulinum toxin type A (BTX‐A) was reported as being effective in reducing muscle‐induced forehead lines, followed by confirming the efficacy of BTX‐A for the reduction of dynamic facial lines. Botox™, now designated onabotulinumtoxinA (BTX‐A Ona), was developed in the USA as the first BTX‐A for aesthetic treatments. It rapidly gained popularity during the 1990s and the early 21st century. In the UK, an alternative type of BTX‐A, abobotulinumtoxinA (BTX‐A Abo), was developed for similar indications. Another approved indication for BTX‐A Ona is the treatment of severe axillary sweating. BTX‐A is now a recognised treatment option for severe localised hyperhidrosis. Three types of BTX‐A currently exist and are approved in Europe and the USA for several aesthetic indications. In addition, botulinum toxin type B (BTX‐B) has distinct pharmacological mechanisms but similar clinical responses to those of type A toxins.