Botulinum Toxin Off-Label Use in Dermatology: A Review

The document from 2017 reviews the off-label use of Botulinum Toxin Type A (BoNT-A) in dermatology, presenting evidence of its potential benefits for a range of conditions including keloids, hypertrophic scars, Hailey-Hailey disease, various genodermatoses, hidradenitis suppurativa, aquagenic keratoderma, different types of alopecia, psoriasis, notalgia paresthetica, facial erythema, oily skin, Raynaud's phenomenon, pompholyx, chromhidrosis, bromhidrosis, eccrine nevus, postherpetic neuralgia, hyperhidrosis, seborrhea, and dermatological manifestations of systemic diseases. Studies and case reports show improvements in symptoms and cosmetic outcomes, such as a 55-patient study demonstrating efficacy in facial wounds, a 24-patient study showing BoNT-A's effectiveness over corticosteroids for keloids, and a 50-male subject study indicating an 18% increase in hair counts for androgenetic alopecia at week 48. However, the document also notes limitations such as small study sizes, the need for more structured trials, and the high cost of BoNT-A. It emphasizes the necessity for further research to confirm BoNT-A's efficacy and safety, establish standardized protocols, and understand the long-term effects and potential for resistance.