This is an evaluation of the treatment efficacy of cosmetic doses of onabotulinumtoxinA (approximately 15-50 units) on the frequency and severity of headaches in patients. This study is marred by its own self-admitted bias, and fault lines exist in the application and subsequent results. A total of 73 patients completed a pre- and post-treatment survey, 45 of whom reported pre-treatment headaches; 44 received onabotulinumtoxinA only, 16 received both onabotulinumtoxinA with hyaluronic acid, and a control group of 13 received hyaluronic acid only. The control group received hyaluronic acid in a dose of 1-2ml injected into nasolabial folds, marionette lines and perioral rhytids. A statistically insignificant decrease in the severity and frequency was reported in this control group. This group in fact reported an increased amount of headache suffering and an associated increase in the self-administration of over the counter (OTC) pain relief medication. Seventy-six percent of the patients who received onabotulinumtoxinA alone experienced a significant decrease in the frequency and severity of headaches. The goal of the study was to assess the application of purely cosmetic doses to relieve headaches. Overall this non-specific study fails to define new perspectives on the issue of onabotulinumtoxinA as a treatment for headaches, and instead reaffirms what prior studies have discovered; that cosmetic / low doses of onabotulinumtoxinA may be adequate to achieve headache relief.

Evaluation of headache relief with cosmetic onabotulinumtoxinA injections.
Goldman ND, Dorton LH, Marcum KK, et al.
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Peter Prendergast

ECAMS Founder and President, Medical Director Venus Medical.

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