What are Neuromodulators/Neurotoxins?
Neuromodulators/Neurotoxins are derived from endotoxin produced by Clostridium botulinum.
There are 9 know toxin types (A-F). A & B are commercially available. There are multiple brands
of neuromodulators on the market and at FPSI we use AbobotulinumtoxinA (Dysport ® ) and
OnabotulinumtoxinA (Botox ® ).
What is the Mechanism of action of Neuromodulators?:
- Neurotoxin enters the distal neuron through receptor-mediated endocytosis and
cleaves SNAP-25 preventing docking and fusion of synaptic vesicles to presynaptic
membrane (necessary for Ach release into the neuromuscular junction). In short,
neuromodulators block chemical signals from nerves that cause muscles to contract. It is
important to note that - Onset: Peak effect 7-14 days
- Duration: lasts 3-4 months (dose equals duration)
- Recovery of function: growth factor secretion from denervated muscle results in active
axonal sprouting and production of new SNAP-25
Cosmetic Indications: - FDA approved: Glabellar and lateral canthal lines (Crow’s feet)
- Off-label: Forehead rhytids, brow elevation, palpebral fissure widening, vertical
perioral and marionette lines, NLFs for “gummy smile”, platysmal bands, hyper
prominent masseter muscles, synkinesis (Bell’s Palsy)
What are the possible complications or neuromodulators?
- Although rare, possible complications include lid ptosis, brow ptosis, facial ptosis, facial asymmetry, dry eyes.
Are there any contraindications to Neuromodulators?
- Known hypersensitivity, egg allergy, active infection at site of injections
- Neuromuscular disease, pregnancy & lactation, concurrent use of
aminoglycoside or muscle relaxants as it potentiates the effects
If you are interested in having a neuromodulator treatment, it is important to receive a
consultation with a licensed professional (Registered Nurse, Advanced Practice Provider such as
an NP/PA, or a Doctor MD/DO) for an individualized plan of care. Learn more on our Botox/Dysport page.
