An Objective Assessment of Botulinum Toxin A Effect on Superficial Skin Texture

In Brief The botulinum toxin A (BTX-A) role on elimination of hyperkinetic wrinkles is consolidated, although relying on subjective methods of assessment. A prospective open-label study was performed on 10 patients to objectively analyze superficial skin texture changes caused by BTX-A in the glabellar area. Skin areas were reproduced by silicon replica technique at baseline, 1 month, and 6 months after treatment. Takahashi's parameters (roughness, anisotropy, microsulcus number, and width) were obtained from scanning electron microscopy (SEM) analysis and compared using the Wilcoxon signed rank test. SEM images showed skin texture changes, and software analysis gave parameters for statistical analysis, allowing an objective evaluation. Statistically significant parameter modifications were evidenced. BTX-A effectiveness in wrinkle treatment was confirmed, and no differences in skin texture parameters from baseline to toxin action end were noted. Scanning electron microscopy was performed on pre- and posttreatment silicone replicas of Botox-injected glabellar skin wrinkles in 10 patients. Improvement was seen in roughness, anisotropy, microsulcus number, and width at 1 month but was no longer present at 6 months.