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Clinical Journaling with TAG: A Review of Top Aesthetic Journal Articles to Kick Off 2023

By The Aesthetic GUIDE posted Feb 10, 2023 05:13 PM



Injectable neurotoxins continue to be a staple of aesthetic practices worldwide, but little is known about the use of this therapy in younger patients.

A recent review investigation appearing in the Journal of Cosmetic Dermatology sheds light on this issue and calls for more research to fill the gap. ‘’When I started practicing 15 years ago, some younger patients wanted wrinkle reduction, but the patient was commonly aged 50 and older,” explained author Alain Michon, MD, medical director of The Ottawa Skin Clinic/Project Skin MD in Ottawa, Ontario, Canada. “There has been a recent shift in the patient demographic with younger patients seeking injectable neurotoxin, but also in the treatment paradigm with prevention in mind, rather than correction.”

Despite this shift, there remains a lack of high-quality research on use of injectable neurotoxins in this patient demographic. In fact, Dr. Michon could only find four papers that fit his basic criteria of age range (under 41 years) and therapy choice (neurotoxin injections for facial cosmetic correction only, no combination therapies). “Only two studies were post hoc analysis of randomized controlled trials, the other two were observational studies,” he explained.

In addition to reviewing the existing research, Dr. Michon also conducted a cross-sectional online survey of aesthetic practitioners to get a sense of current practices. “There is always pressure from manufacturers to adhere strictly to recommended dosages, but we all know that, in practice, this does not happen. As a community, we rely on the science, but we also rely on our clinical experience to determine safe and effective dosages, partly aligned with patient desires for correction.”

According to Dr. Michon, the findings suggest that injectable neurotoxin is effective, as expected, but there is much to be learned from the dosing patterns and motivational factors among the younger population. “Our work showed that this population tends to receive smaller doses for the common injection targets and are looking for prevention, rather than correction,” he said. “Furthermore, they want to avoid an unnatural or ‘frozen’ look.”

“We are also seeing a movement toward more neurotoxin microinjection for management of skin quality, called ‘microtox,’ which understandably appeals to the younger population because of their stated goals,” he added. “As practitioners, we need to have a total consultation in an effort to understand the patient’s aims. More study of this would be revealing.”

Dr. Michon also noted that patient goals are not always considered in research. “We see studies that determine efficacy of dosages –the issue of dose-response – but not how this may correlate with what the patient was hoping to achieve. There is a psychosocial aspect in this field of medicine that is very important to account for, especially as we trend toward more holistic approaches in the industry.”

This is a sample article from The Aesthetic Guide.

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