Lanzl I, Merté R-L
Augenklinik der TU München, Ismaninger Strasse 22, 81675 München.
Ophthalmologe. 2007 Sep;104(9):777-82. doi: 10.1007/s00347-007-1614-x.
The use of botulinum toxin A for the treatment of wrinkles is increasing. Botulinum toxin A inhibits exocytosis of acetylcholine from 3 to 12 months, depending on the target tissue. Low-dose botulinum toxin A is used to smooth hyperkinetic facial lines. This is especially successful in the upper facial parts, since the target muscles (procerus, corrugator supracilii, frontalis, orbicularis oculi) all directly overlie the osseous structures of the face. This is not the case for the lower facial parts, and more side effects are encountered when treating, for example, wrinkles around the mouth. Contraindications to the use of botulinum toxin A are diseases affecting neuromuscular signal transduction, allergic reactions to components of the solution, therapy with aminoglycosides or acetylsalicylic acid prior to treatment, infections in the planned treatment area, and pregnancy and lactation. Alternative and complementary treatments include erbium-YAG or CO2 laser, as well as augmentation and surgical plastic procedures.
A型肉毒杆菌毒素用于治疗皱纹的情况日益增多。根据靶组织不同,A型肉毒杆菌毒素可在3至12个月内抑制乙酰胆碱的胞吐作用。低剂量A型肉毒杆菌毒素用于抚平面部运动过度产生的皱纹。这在上半面部尤其成功,因为靶肌肉(降眉间肌、皱眉肌、额肌、眼轮匝肌)均直接覆盖面部骨骼结构。下半面部则并非如此,例如在治疗口周皱纹时会出现更多副作用。使用A型肉毒杆菌毒素的禁忌证包括影响神经肌肉信号转导的疾病、对溶液成分的过敏反应、治疗前使用氨基糖苷类药物或乙酰水杨酸、计划治疗区域的感染以及妊娠和哺乳期。替代和辅助治疗包括铒-钇铝石榴石激光或二氧化碳激光,以及填充和外科整形手术。