摘要
Objective:Botulinum toxin type A is frequently used to treat crow’s feet lines.However,the optimal dose and injection sites are still controversial.The objective of this study was to compare the efficacy of different botulinum toxin type A injection patterns for the treatment of crow’s feet.Methods:This single-center,retrospective,clinical study was conducted at the National Hospital of Dermatology and Venereology from July 2020 to December 2020.Data on 60 patients with crow’s feet were collected and divided into 2 groups(3-or 4-point intramuscular injection)according to the intramuscular injection technique the patients received.The treatment efficacy was assessed based on the changes in the Crow’s Feet Grading Scale score at 1,4,and 16 weeks after treatment.Repeated measures analysis of variance was used for the assessment of changes in scores over time between the two groups.Results:After treatment,the average Crow’s Feet Grading Scale score was significantly decreased compared with the pretreatment score at all timepoints(1,4,and 16 weeks)in both states(dynamic:For 3-point intramuscular injection technique,1 week:1.90±0.71 vs.2.97±0.56;4 weeks:1.87±0.68 vs.2.97±0.56;16 weeks:2.60±0.67 vs.2.97±0.56.For 4-point intramuscular injection technique,1 week:1.73±0.83 vs.3.03±0.49;4 weeks:1.73±0.74 vs.3.03±0.49;16 weeks:2.57±0.68 vs.3.03±0.49,all P<0.001.and static:For 3-point intramuscular injection technique,1 week:1.20±0.89 vs.2.20±0.85;4 weeks:1.20±0.89 vs.2.20±0.85;16 weeks:1.87±0.97 vs.2.20±0.85;For 4-point intramuscular injection technique,1 week:1.50±0.86 vs.2.30±0.84;4 weeks:1.33±0.84 vs.2.30±0.84;16 weeks:1.87±0.97 vs.2.30±0.84.All P<0.001).The average subjective patient-rated satisfaction scores after treatment were significantly higher in the 4-point injection group than in the 3-point injection group(P=0.028).The adverse events were post-injection bruising in 3 patients and a feeling of eyelid tightness in 3 patients.Conclusion:Botulinum toxin type A injection is an effective treatment for crow’s feet.Adding a fourth injection maintains the same therapeutic effect and does not increase adverse effects.Patients with lower-fan crow’s feet patterns may benefit more from 4-point injection therapy.However,the present findings require confirmation in studies with larger sample sizes,longer follow-up times,and different botulinum toxin type A doses.
