Temporary Facial Blanching After Botulinum Toxin Injection in Asians: A Case Report and Literature Review

This case report documents the first known instance of temporary facial blanching in an Asian patient following Botulinum toxin type A (BTX-A) injection. A 34-year-old Asian female experienced localized blanching on her forehead and outer canthus after receiving BTX-A injections for forehead wrinkles and female pattern hair loss. The blanching persisted for 96 hours before resolving without causing discomfort. The report explores potential mechanisms, including the impact of BTX-A on neurovascular dynamics, such as reduced blood flow and inhibition of acetylcholine signaling. To prevent such complications, clinicians are advised to use lower doses, avoid vascular networks, and ensure proper toxin dilution. The study emphasizes the need for further research into vascular complications of BTX-A across different ethnicities and highlights the importance of patient education on potential side effects.