The practice of injecting botulinum toxins to reduce hyperdynamic perioral lines has become increasingly popular. However, concerns remain regarding the overall efficacy of such treatments and the proper dosing for treatment in this area of the face. In an effort to determine adequate and safe guidelines, researchers led by Joel L. Cohen, MD, studied 60 female patients. The patients received onabotulinumtoxinA injections at four sites totaling 7.5 units or 12 units. Perioral lines (POL) and total lip satisfaction (TLS) were rated at followup visits 2, 4, 8, 12, 16 and 20 weeks after treatment. The study, published in Dermatologic Surgery (September 2012), found that POL severity was reduced through week 20 for patients who received 12 units and through week 16 for patients who received 7.5 units. Subject-assessed TLS was improved at all visits through week 16. Adverse events increased with the higher dosage, leading the researchers to conclude, “OnabotulinumtoxinA provides significant reductions in POL severity and high levels of subject satisfaction. Lack of dose response and fewer AEs suggest that treatment of hyperdynamic POLs with 7.5 U appears adequate for up to 16 weeks.”
