The author gives a detailed review of the advice that is routinely offered to patients following treatment with botulinum toxin, as well as the available evidence to substantiate current recommendations. There is a detailed description of the mechanism of action of BoNTA, in relation to the types of toxin available in the UK. In spite of a paucity of available data concerning the risk of localised skin infection following BoNTA injection, the literature consistently recommends avoidance of touching the treated area, and avoiding the use of make up for 12 hours. There is an interesting discussion concerning the spread and migration following treatment, and the author concludes a lack of evidence regarding the effects of rubbing or massaging post-treatment, in relation to affecting the movement of toxin. Current evidence concerning cooling of the skin is further explored, with recommendations to avoid, pending further investigation. The author draws on credible literature to concur that the greatest variables that affect the migration and spread of BoNTA from the target site included dose, concentration and volume injection; the larger the volume of injection, the greater the risk of migration from the target site. In addition, the evidence surrounding exercise post-injection, as well as UV exposure, travel and muscle activity are critically explored with recommendation for further study where insufficient data is available. A useful update on the current evidence for post treatment care for BoNTA. 

Post-treatment advice following botulinum toxin injections: a review.
Patel S.
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Anna Baker

BJN Aesthetic Nurse of the Year 2016.

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