Geographic Variation in Botulinum Toxin Type A Longevity: A Pilot Comparative Study Between Saint Petersburg and Ashgabat

The clinical duration of botulinum toxin type A (BoNT-A) is commonly associated with anatomical factors, yet environmental influences remain an area of clinical interest. This observation, based on clinical practice in Saint Petersburg and Ashgabat, explores potential variations in neuromodulator requirements across different climatic zones. It has been hypothesized that chronic solar exposure may be associated with differences in facial muscle engagement and aesthetic treatment outcomes; however, this relationship was not directly evaluated in the present study. The purpose of this pilot investigation was to explore whether differences in BoNT-A dosage requirements and treatment longevity could be observed between two geographic cohorts residing in regions with different climatic and ultraviolet (UV) environments. Some patients underwent platelet-rich plasma (PRP) therapy or biorevitalization as part of routine clinical practice prior to BoNT-A administration. However, the present study was not designed to evaluate the effectiveness of these interventions. These observations are intended to highlight the need for further investigation of potential climate-related factors influencing aesthetic treatment outcomes.