Epidemiologic analysis of change in eyelash characteristics with increasing age in a population of healthy women.

BACKGROUND: Observations that eyelashes become thinner, shorter, and lighter, as women age has not been previously quantified. OBJECTIVE: This study was conducted to investigate associations between eyelash characteristics and age. MATERIALS AND METHODS: The upper natural eyelashes of 179 subjects were photographed and analyzed (digital image analysis); length, thickness, and darkness (intensity: 0 = white and 255 = black) were calculated. Linear regression, including race as a potentially confounding factor, was used to assess the association between age and mean eyelash characteristics. RESULTS: Subjects' mean age was 40.3 (±10.3) years; 46.1% were white, 36.5% Asian, 9.0% Hispanic, 5.1% East Indian, and 3.4% black. Mean eyelash length ranged from 6.39 (±1.02) to 7.98 (±1.15) mm (subjects aged 50-65 years and 22-29 years, respectively). Mean thickness ranged from 1.17 (±0.42) to 1.62 (±0.56) mm (subjects aged 50-65 years and 20-29 years, respectively). Mean intensity ranged from 118.2 (±19.8) to 129.4 (±17.3) (subjects aged 30-39 years and 50-65 years, respectively). Adjusted for race, eyelash length, thickness, and darkness decreased significantly with increasing age (p < .000, p = .0090, and p < .05, respectively). CONCLUSION: Advancing age among an ethnically diverse population of healthy women is associated with significant decreases in eyelash length, thickness, and darkness.

OnabotulinumtoxinA dose-ranging study for hyperdynamic perioral lines.

BACKGROUND: Few dosing data on onabotulinumtoxinA to treat hyperdynamic perioral lines (POLs) are available. Studying onabotulinumtoxinA in controlled settings is beneficial to treating a hyperfunctional orbicularis oris. OBJECTIVE: To compare the dose-response relationship of two doses of onabotulinumtoxinA in hyperdynamic POLs. METHODS: Female subjects (N = 60) received injections of onabotulinumtoxinA at four sites totaling 7.5 U or 12.0 U. Subjects returned at weeks 2, 4, 8, 12, 16, and 20. POL severity and total lip satisfaction (TLS) were assessed at all visits. RESULTS: Investigator-assessed POL severity was reduced through week 20 for 12.0 U (p < .01). POL reduction for 7.5 U persisted until week 16 (p < .05). Responder rates did not differ until week 12 (12.0 U, 77%; 7.5 U, 36%; p = .003). Subject-assessed TLS was improved (p < .05) at all time points for both groups except at week 20 (12.0 U; p = .06). Most adverse events (AEs) were mild to moderate in severity and typical for onabotulinumtoxinA treatment in the lips, and the incidence was dose-dependent. CONCLUSION: OnabotulinumtoxinA provides significant reductions in POL severity and high levels of subject satisfaction. Lack of dose response and fewer AEs suggest that treatment of hyperdynamic POLs with 7.5 U appears adequate for up to 16 weeks.

Long-term treatment of glabellar rhytides using onabotulinumtoxina.

OBJECTIVE: To determine whether injection every 4 months with onabotulinumtoxinA provides longer-lasting reduction or elimination of glabellar rhytides. METHODS: Toxin-naive women (N=45) aged 30 to 50 with moderate to severe glabellar lines at maximum contraction completed the study. Five sites were treated with 4 U of onabotulinumtoxinA. Participants were assessed at day 30; those with glabellar severity of none to mild remained in the study. Participants received identical treatments at months 4, 8, 12, 16, and 20, and were assessed without treatment at 24, 25, and 26 months. RESULTS: Baseline physician- and participant-rated treatment responders at maximum contraction were 84% and 80%, respectively, at month 20; and 56% and 58%, respectively, at month 26. Mean changes from physician- and participant-assessed Facial Wrinkle Scale at maximum contraction from baseline to all postbaseline measurements were significant (p≤.001). The percentage of participants reporting neutral (0) to couldn't be more satisfied (+4) with their appearance ranged from 91% to 100% during months 1 to 24. At month 26, 87% of participants reported satisfaction, with appearance scores between 0 and +4. No adverse events were reported. CONCLUSIONS: OnabotulinumtoxinA delivered for 20 months significantly reduces or progressively eliminates glabellar rhytides for up to 6 months after the last treatment.

Multicenter, randomized, parallel-group study of the safety and effectiveness of onabotulinumtoxinA and hyaluronic acid dermal fillers (24-mg/ml smooth, cohesive gel) alone and in combination for lower facial rejuvenation.

BACKGROUND: Combination treatment with toxins and fillers is the standard regimen in facial rejuvenation. Systematic studies of botulinum toxin alone and in combination with hyaluronic acid (HA) have not, however, been conducted in the lower face. OBJECTIVE: To evaluate safety and effectiveness and compare combination treatment with onabotulinumtoxinA and a 24-mg/mL smooth, cohesive HA gel filler with either treatment alone for rejuvenation of the perioral area and lower face in female subjects. METHODS: Ninety female participants aged 35 to 55 were randomized to one of three groups: 24-mg/mL cohesive gel alone (n=30), onabotulinumtoxinA alone (n=30), or the combination (n=30). Effectiveness outcomes included perioral, lip fullness, and oral commissure assessments and scores on the Cosmetic Improvement and Global Aesthetic Improvement Scales. Adverse events were monitored throughout. RESULTS: For all end points and most time points, subjects treated with onabotulinumtoxinA plus the 24-mg/mL cohesive gel had greater improvement from baseline than subjects treated with onabotulinumtoxinA or the 24-mg/mL cohesive gel filler alone. CONCLUSION: Based on a range of end points, onabotulinumtoxinA and 24-mg/mL cohesive HA gel treatments are effective and safe when either alone or in combination to rejuvenate the lower face. Combination therapy is superior to either modality used alone.