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Biomedical subjects

Alastair Carruthers

Publications and source records attributed to Alastair Carruthers.

30 records · Page 2Linked to original sources
PubMed2003

Aesthetic botulinum A toxin in the mid and lower face and neck.

BACKGROUND: Botulinum toxin type A (BOTOX formulation) is used extensively for smoothing hyperkinetic lines in the upper face. The use of botulinum toxin for aesthetic indications in the mid and lower face and neck is now becoming increasingly popular. OBJECTIVE: To review our current approaches to botulinum toxin treatment for cosmetic indications in the mid and lower face and neck. METHODS: Procedures and outcomes are described for the primary and adjunctive use of botulinum toxin. RESULTS: Cosmetic treatment with botulinum toxin successfully changes the contour of the palebral aperture; smoothes lines, including "bunny" lines, perioral rhytides, and horizontal neck lines; softens creases, including the mental crease and melomental folds; and alleviates facial asymmetry and nasal flare. The doses of botulinum toxin used in the mid and lower face are generally lower than those used in the upper face. Caution must be used in injecting botulinum toxin in the perioral area to avoid an incompetent mouth. CONCLUSION: Botulinum toxin treatment is valuable for aesthetic improvements in the mid and lower face and neck. In some areas, particularly the perioral region, the use of botulinum toxin in combination with other therapeutic modalities provides optimal results.

Botulinum Toxins, Type A↗
PubMed2003

Deep resting glabellar rhytides respond to BTX-A and Hylan B.

BACKGROUND: BTX-A is the standard treatment for glabellar furrows. However, some individuals have resting glabellar rhytides that are sufficiently deep that they respond poorly to BTX-A alone. OBJECTIVE: To compare the efficacy of BTX-A combined with intradermal Hylan B with the efficacy of BTX-A alone in individuals with moderate to severe glabellar rhytides. METHODS: This was a retrospective study of 16 subjects with moderate to severe glabellar rhytides. Their response to Hylan B plus BTX-A was compared clinically and photographically to their response to BTX-A alone. RESULTS: All subjects had moderate or severe glabellar rhytides at rest before treatment. After BTX-A alone, none (0%) had achieved no or mild rhytides. After BTX-A and Hylan B injection, only 1 of 16 (6%) had moderate glabellar rhytides, with the remainder (94%) being mild. CONCLUSION: Moderate to severe glabellar rhytides were treated better by BTX-A combined with Hylan B injection than by BTX-A alone.

Adult↗
PubMed2003

A prospective, randomized, parallel group study analyzing the effect of BTX-A (Botox) and nonanimal sourced hyaluronic acid (NASHA, Restylane) in combination compared with NASHA (Restylane) alone in severe glabellar rhytides in adult female subjects: treatment of severe glabellar rhytides with a hyaluronic acid derivative compared with the derivative and BTX-A.

BACKGROUND: Over the past 15 years, BTX-A has become the standard treatment for dynamic glabellar furrowing. Some individuals have resting glabellar rhytides that are sufficiently deep that they respond poorly to BTX-A alone. OBJECTIVE: To compare the efficacy of BTX-A combined with intradermal nonanimal stabilized hyaluronic acid (NASHA) with the efficacy of NASHA alone in females with moderate to severe glabellar rhytides. METHODS: This was a prospective randomized study of 38 subjects with moderate to severe glabellar rhytides. Half of the subjects were treated with BTX-A and NASHA and the other half with NASHA alone. Their response was assessed clinically and photographically. RESULTS: By comparison with the NASHA-alone group, the BTX-A plus NASHA group showed a better response both at rest and on maximum frown, and this response was maintained for longer. The median time for return to preinjection furrow status occurred at 18 weeks in the NASHA-alone group compared with 32 weeks for the BTX-A plus NASHA group.

Adult↗
PubMed2003

Botulinum toxin A: its expanding role in dermatology and esthetics.

The use of botulinum toxin A in cosmetic dermatology has increased in popularity due to the efficacy and relative safety of the treatment. Botulinum toxin A is one of eight exotoxins produced by Clostridium botulinum, a Gram-positive, spore-forming anaerobe. Flaccid paralysis results from the denervation of muscle fibers at the neuromuscular junction after botulinum toxin A administration. While treating blepharospasm, the Carruthers incidentally found that botulinum toxin A improved glabellar frown lines. Dynamic rhytides occur in areas of dynamic motion. These types of lines may be improved with botulinum toxin A. There are two types of botulinum toxin A commercially available (BOTOX and Dysport); only BOTOX is currently available in the US. The efficacy and tolerability of BOTOX was best demonstrated with a multicenter, double-blind, randomized, placebo-controlled study of the efficacy and safety of botulinum toxin type A in the treatment of glabellar lines in 264 patients. There was a significantly greater reduction in glabellar line severity with BOTOX. The effect was maintained for the duration of the study (120 days). There was low occurrence (5.4%) of mostly mild blepharoptosis in the BOTOX group. In another prospective study, it was found that about 1% of BOTOX patients reported severe headache. Botulinum toxin A can provide an alternative treatment of palmar and axillary hyperhidrosis when options such as topical agents (aluminum chloride) and iontophoresis have failed.

Botulinum Toxins, Type A↗
PubMed2002

The skin in pregnancy.

BACKGROUND: Physiologic skin changes are common during pregnancy due to a temporary shift in hormonal, metabolic, and immunologic factors. Physicians may mistake normal skin changes in pregnancy as pathologic change within the skin, and so an appreciation of the common and less common skin manifestations will assist in appropriate patient care. OBJECTIVE: This review highlights the normal physiologic skin changes in pregnancy, which include pigmentary changes, changes to the hair and nails, alterations in glandular activity, vascular and hematological changes, cutaneous tumors, and mucous membrane changes. CONCLUSION: Physiologic changes to the skin in pregnancy can be complex and confusing. Pregnancy can be a stressful time for women so it is imperative that physicians be aware of the normal skin changes during pregnancy in order to prevent unnecessary investigations and treatments.

Diagnosis, Differential↗
PubMed2002

HIV-associated facial lipoatrophy.

BACKGROUND: HIV-infected individuals are living long, healthy lives. They are now concerned with less life-threatening problems, especially lipodystrophy. OBJECTIVE: To review the current state of our knowledge about lipodystrophy in HIV-infected individuals. METHODS: The literature was reviewed and analyzed for relevant information. In addition, our clinical experience of managing such individuals was utilized. RESULTS: Lipodystrophy and facial lipoatrophy and their relationship to HIV-infection are discussed. Their differences are noted. The spectrum of appearance in individuals with facial lipoatrophy is described and a severity scale suggested which should be of value in assessing the results of treatment. CONCLUSION: Lipodystrophy and lipoatrophy are intimately related to infection with HIV. In consequence, facial lipoatrophy is a major stigma for HIV-infected individuals and can have dramatic effects on their self-esteem and socialization. Effective treatment is essential.

Antiretroviral Therapy, Highly Active↗
PubMed2002

Botulinum toxin type A: history and current cosmetic use in the upper face.

This article reviews the cosmetic use of botulinum toxin in upper face from both the historic and clinical viewpoints. The published literature and our current experience are outlined. Botulinum toxin type A in the upper face has become an extremely popular cosmetic procedure and is outstandingly safe.

Botulinum Toxins, Type A↗
PubMedDate not supplied

History of the clinical use of botulinum toxin A and B.

The history of the cosmetic use of botulinum toxin (BTX) must begin with the clinical use of BTX in humans. This came out of Alan Scott's work, which was initially an attempt to find a nonsurgical treatment for some forms of strabismus. Alan Scott put together the idea of Ed Maumenee to use BTX to affect extraocular muscles, Art Jampolsky's electromyographic control delivery system, and Ed Schantz' work on the purification of BTX.

Botulinum Toxins↗
PubMedDate not supplied

Botox: beyond wrinkles.

First used and approved over a decade ago for the treatment of strabismus (or misaligned eyes), botulinum toxin (BTX) has demonstrated efficacy in blepharospasm, hemifacial spasm, spastic lower eyelid entropion, and a number of other disorders seen in the traditional medical environment that are characterized by abnormal muscle contraction. Moreover, other conditions-notably some pain and gastrointestinal disorders-have responded to BTX injections.

Botulinum Toxins↗