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Botulinum Toxin May Hold Untapped Potential for Common Skin Diseases

Posted: March 1, 2013

Overview

While botulinum toxin type A has gained accolades as a wrinkle fighter, the use of this neuromodulator in dermatology represents a very small percentage of its use in the field of medicine. Now, researchers are gaining a better understanding of how botulinum toxin type A interacts with blood vessels and nerves and are encouraged by its enormous potential for future breakthroughs in medicine, particularly in the treatment of inflammatory skin diseases, such as psoriasis and eczema.

AAD Expert

Information provided by Erin Gilbert, MD, PhD, FAAD, a board-certified dermatologist and assistant professor of dermatology at SUNY Downstate in Brooklyn, N.Y.

An Alternative to Steroids

Gilbert explained that a quandary in dermatology is the widespread use of steroids in treating inflammatory skin diseases. Although topical and oral steroids boast a proven track record for curbing the bothersome inflammation of skin conditions, dermatologists are constantly looking for alternatives to balance the therapies’ side effects—notably thinning and lightening of the skin and the development of new blood vessels. While very little is known about the interaction between blood vessels and nerves in the skin, dermatologists are optimistic that new research exploring how botulinum toxin type A can influence this interaction could lead to a new therapy for chronic inflammatory skin conditions.

Psoriasis

Psoriasis is a chronic skin condition that affects an estimated 7.5 million Americans and is the most prevalent autoimmune disease. One animal-model study conducted by Gilbert in collaboration with Nicole L. Ward, PhD, at Case Western Reserve University in Cleveland, found promising results using botulinum toxin type A to target psoriasis.¹ In this mouse-model psoriasis study, Gilbert and Ward showed that botulinum toxin injections improved the clinical appearance of psoriasis and decreased the presence of specific cells in the affected skin of the mouse, while also reducing the number of blood vessels and their adjacent nerves.

  • The decreased number of blood vessels within the affected skin of the treated mice illustrates the role of nerves and blood vessels in perpetuating the appearance of an inflammatory skin disease, such as psoriasis. It brings to light the role of blood vessel and nerve communication in psoriasis and the potential role of botulinum toxin in blocking this communication.

Eczema