Kosmetische Medizin 3-2010: 146 – 150

COMPARATIVE STUDY ABOUT OBJECTIVE WRINKLE DEPTH MEASUREMENT AFTER INJECTION OF BOTULINUM TOXIN TYPE A
Assessment of the efficacy of a botulinum toxin type A free of complexing proteins (Bocouture®) in patients with glabellar lines using the Facial Wrinkle Scale (FWS) and an objective high-tech measurement process (PRIMOS) to investigate the severity of wrinkles reduction

BERND KARDORFF1, 2, MICHAELA MENZINGER1, PETER DORITTKE1, 2

KEY WORDS: Botulinum neurotoxin type A, glabellar lines, Bocouture®, measurement of severity of wrinkles, structured light projection, 3D in-vivo skin measurement

SUMMARY:
The use of botulinum toxin type A for treatment of glabellar lines is one of the most common procedures in aesthetic dermatology. With Bocouture® recently a botulinum neurotoxin type A is available, free of complexing proteins, approved for the treatment of glabellar lines. In this study, the efficacy of 24 units Bocouture® in 20 patients with moderate to severe glabellar lines was investigated by two independent measurement techniques. The severity of wrinkles was assessed by the fourpoint Facial Wrinkle Scale (FWS) and the average depth of wrinkles by optical 3D-measurement of the skin surface using the PRIMOS structured light projection measurement process.

2 weeks after treatment the severity of wrinkles (FWS) was reduced by 82 %. All the patients showed as responders an improvement in FWS of at least one point. After 4 months the severity of wrinkles was still 20 % below baseline. Even at rest there was a decline in severity of wrinkles by more than 50 % after 2 weeks and about 25 % reported after 4 months respectively. The mean wrinkle depth at full forced frown, measured with the PRIMOS procedure, was 2 weeks after Bocouture® application about 70 % reduced and at 4 months still 24 % below baseline. With relaxed muscles after 2 weeks a reduction of 28 % of the average depth of wrinkles could be observed and was still reduced by 18 % after 4 months respectively.

Our study shows that both measurement methods (FWS and PRIMOS) are providing similar results. The so called “mean wrinkle depth” which takes into account the whole wrinkle volume measured by the PRIMOS system, proved to be an excellent parameter to objectively measure the efficacy of botulinum neurotoxin type A for glabella lines.

The parameter “maximum wrinkle depth” could not be measured precisely in very deep wrinkles based on the fact that by PRIMOS only the vertical “visible area” is measured. The in deeper dynamic wrinkles overlapping folds of skin inhibit the systems view to the vertical maximum wrinkle depth.

Both measurement methods used in this study (FWS and PRIMOS) showed a marked decrease in average severity and depth of wrinkles and thus confirm the good efficacy of Bocouture® for glabellar lines in practice.

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