This single blinded randomized pilot study was performed on 21 Caucasian females to
determine if injections through follicular openings were less painful than traditional
injections for cosmetic botulinum toxin type A injections.
Objective: To investigate whether injection of botulinum toxin type A is less painful if
performed through follicular openings versus traditional non-specific approach.
Design: Prospective, randomized, single-blinded study.
Setting: Academic dermatology department.
Patients: A volunteer sample of twenty female patients aged 25-55 who had no prior history
of botulinum toxin injection.
Intervention: Each patient received six randomized injections of botulinum toxin type A
(Botox® Allergan). Two injections into the procerus muscle and two into each corrugator
muscle. Three of the injections were performed through follicular openings and three were
Main Outcome Measure: Patient discomfort on a 1-10 scale and direct comparison between the
two injection techniques.
- No prior history of botulinum toxin
- Age 25-55
- Prior history of botulinum toxin
- Neuromuscular disorders
- Aminoglycoside therapy