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Combination Treatment Effective for Crow's Feet

Small study demonstrates short-term efficacy of combining botulinum toxin and epinephrine

THURSDAY, April 12 (HealthDay News) -- A combination of botulinum toxin type A and epinephrine may produce quicker and more noticeable results in the treatment of crow's feet than botulinum toxin alone, according to the results of a small study published in the April issue of Dermatologic Surgery.

Basil M. Hantash, M.D., Ph.D., of Stanford University Medical Center in Stanford, Calif., and a colleague conducted a split-face randomized double-blind study of 14 patients, aged 39 to 57, with severe periorbital rhytides. They evaluated the subjects at baseline, four days and one, three and six months later.

The researchers found that treatment with botulinum toxin type A plus epinephrine led to higher subjective and objective improvement scores than treatment with botulinum toxin alone at four days, one month and three months. With both treatments, improvements peaked at three months and declined during months four, five and six. No serious adverse events were observed with either treatment.

"With a 30 and 45 percent improvement in efficacy by four and 30 days, respectively, it is easy to justify the minimal cost (1-mL ampule of EPI 1:1,000 is less than $3) of the addition of epinephrine" to botulinum toxin type A, the authors write.

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