• Written By: Robert A. Goldberg, MD and Mehryar Taban MD

    The authors report the use of topical botulinum neurotoxin type A (BoNTA) cream (CosmeTox) as an alternative to injections to treat dynamic facial wrinkles in a randomized placebo-controlled study of 40 female patients who were followed for 12 weeks. The cream can be an alternative treatment for those who are either afraid of needles or unable to attend a physician's office on a routine basis. The study found that CosmeTox produced significant improvements in the Facial Lines Outcome scores, which were maintained throughout the study period and lasted more than three months.

    However, the prolonged nightly treatment can be impractical and slow for most. Furthermore, the cream can be applied to unwanted facial regions by patients who are not sophisticated in facial anatomy.