Vachiramon V, Subpayasarn U, Triyangkulsri K, Jurairattanaporn N, Rattananukrom T
Division of Dermatology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
J Eur Acad Dermatol Venereol. 2021 Jan;35(1):256-262. doi: 10.1111/jdv.16997. Epub 2020 Dec 21.
IncobotulinumtoxinA has been previously used for the treatment of lateral periorbital lines (crow's feet). However, a standardized injection technique has not been established.
To compare the efficacy and effect duration of two injection techniques of incobotulinumtoxinA for crow's feet treatment.
Forty-eight patients with crow's feet were recruited and randomly assigned to receive bilateral treatments using either a 3-point intramuscular or a 6-point intradermal injection technique (8-12 units of incobotulinumtoxinA on each side). Improvement was assessed at 1, 2, 4, 8, 12, 16, 20 and 24 weeks postinjection. An objective evaluation was assessed by the indentation index using a 3D camera and a subjective evaluation was assessed by a blinded dermatologist using the Flynn validated assessment scale (FVAS) for the upper face. The patients assessed the results using the Global Aesthetic Improvement Scale (GAIS). Side-effects were evaluated at each visit.
After treatment, a significantly greater reduction in the indentation index of periorbital wrinkles on the 3-point intramuscular injection side compared with the 6-point intradermal injection side was observed at 8, 12, and 16 weeks. The results from the FVAS and GAIS scores showed significantly longer median times to relapse of the periorbital wrinkle for the 3-point intramuscular injection compared with the 6-point intradermal injection. Pain and bruising were slightly greater with the 6-point intradermal technique.
This study reaffirmed the efficacy of incobotulinumtoxinA for the treatment of crow's feet. The 3-point intramuscular injection technique yielded greater efficacy and longer duration of action than the 6-point intradermal injection technique.
IncoBotulinumtoxinA（英恪保妥适A型肉毒毒素）此前已用于治疗眶外侧纹（鱼尾纹）。然而，尚未建立标准化的注射技术。
比较IncoBotulinumtoxinA两种注射技术治疗鱼尾纹的疗效和作用持续时间。
招募48例有鱼尾纹的患者，随机分配接受双侧治疗，采用三点肌肉注射或六点皮内注射技术（每侧注射8 - 12单位IncoBotulinumtoxinA）。在注射后1、2、4、8、12、16、20和24周评估改善情况。通过使用3D相机的压痕指数进行客观评估，由一名盲法皮肤科医生使用针对上睑的Flynn验证评估量表（FVAS）进行主观评估。患者使用全球美学改善量表（GAIS）评估结果。每次就诊时评估副作用。
治疗后，在8、12和16周时，观察到三点肌肉注射侧眶周皱纹的压痕指数较六点皮内注射侧有显著更大程度的降低。FVAS和GAIS评分结果显示，与六点皮内注射相比，三点肌肉注射的眶周皱纹复发中位时间显著更长。六点皮内技术的疼痛和瘀伤略更严重。
本研究再次证实了IncoBotulinumtoxinA治疗鱼尾纹的疗效。三点肌肉注射技术比六点皮内注射技术产生更大的疗效和更长的作用持续时间。
