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Dose Requirements for Glabellar Botulinum Toxin Higher in High-Sun Climate

Low sun-exposure group had significantly lower total dose requirements in multivariable analyses correcting for age

By Elana Gotkine HealthDay Reporter

FRIDAY, July 19, 2024 (HealthDay News) — To achieve maximal paralysis, patients injected with glabellar botulinum toxin may have significantly higher dose requirements in a high sun-exposure environment, according to a study published in the July issue of Plastic and Reconstructive Surgery.

Kim L. Borsky, M.B.B.S., M.D., from the Stoke Mandeville Hospital in the United Kingdom, and colleagues conducted a comparative cohort study using data from a registry from a single provider practicing in the United Kingdom (low sun exposure) and Malta (high sun exposure). Women aged 35 to 60 years undergoing glabellar botulinum toxin treatment following standard procedures from 2012 to 2019 were included; patients received top-up doses until full clinical paralysis was achieved. Data were included for 523 patients: 292 with high sun exposure and 231 with low sun exposure.

The researchers found that the mean total doses were significantly higher in the high versus low sun-exposure group (29.2 versus 27.3 units). The low-sun group still had significantly lower total dose requirements when correcting for age in multivariable analyses.

“Rigid protocols about doses and distributions may lead to undertreatment if applied in sunnier climates,” the authors write. “Treatment protocols may need to account for the climate in which treatments are being undertaken to achieve more predictable results.” 

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