The Effect of Micro-Focused Ultrasound Treatment on Intradermal Botulinum Toxin Type A Injection

Botulinum toxin type A (BoNT-A) injection and micro-focused ultrasound with visualization (MFU-V) are becoming increasingly popular for various esthetic conditions. However, performing MFU-V subsequently to BoNT-A injection may diminish the efficacy of BoNT-A. Previous reports have indicated the imp...

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Main Authors: Sarawin Harnchoowong, Natthachat Jurairattanaporn, Vasanop Vachiramon
Format: Article
Language:English
Published: MDPI AG 2025-03-01
Series:Toxins
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Online Access:https://www.mdpi.com/2072-6651/17/3/147
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author Sarawin Harnchoowong
Natthachat Jurairattanaporn
Vasanop Vachiramon
author_facet Sarawin Harnchoowong
Natthachat Jurairattanaporn
Vasanop Vachiramon
author_sort Sarawin Harnchoowong
collection DOAJ
description Botulinum toxin type A (BoNT-A) injection and micro-focused ultrasound with visualization (MFU-V) are becoming increasingly popular for various esthetic conditions. However, performing MFU-V subsequently to BoNT-A injection may diminish the efficacy of BoNT-A. Previous reports have indicated the impact of various energy-based devices on BoNT-A. Nevertheless, the influence of MFU-V on BoNT-A has yet to be investigated. Thus, this study aims to evaluate the effect of MFU-V on BoNT-A injection and to determine the optimal interval between each treatment. A randomized controlled study was conducted on 15 subjects. Each participant was assigned to receive four sites of intradermal BoNT-A injection on their forehead. Following BoNT-A injection, these locations were randomized to receive either no MFU-V treatment or further treatment with MFU-V (superficial transducer, 10.0 MHz, 1.5 mm) on the same day, Day 7, or Day 14. On Day 28 following injection, the anhidrosis area was measured using the iodine starch test to objectively evaluate the result. In comparison to the control site (1.10 cm<sup>2</sup>), the anhidrotic area was significantly smaller in all MFU-V treated sites (0.74 cm<sup>2</sup> in immediate MFU-V treatment, <i>p</i> < 0.001; 0.90 cm<sup>2</sup> in MFU-V Day 7, <i>p</i> = 0.005; 0.93 cm<sup>2</sup> in MFU-V Day 14, <i>p</i> = 0.021). There were no serious and esthetic complications reported in our study. <b>In conclusion,</b> MFU-V with a superficial depth transducer significantly reduced the efficacy of intradermal BoNT-A injection, especially within two weeks following BoNT-A injection. After BoNT-A injection, we recommend MFU-V treatment should be avoided for at least two weeks. Further study is required to evaluate the optimal interval between these two treatments.
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spelling doaj-art-3ba5dbe5c0374d6da5082a7d2102f0532025-08-20T01:48:56ZengMDPI AGToxins2072-66512025-03-0117314710.3390/toxins17030147The Effect of Micro-Focused Ultrasound Treatment on Intradermal Botulinum Toxin Type A InjectionSarawin Harnchoowong0Natthachat Jurairattanaporn1Vasanop Vachiramon2Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Ratchathewi, Bangkok 10400, ThailandDivision of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Ratchathewi, Bangkok 10400, ThailandDivision of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Ratchathewi, Bangkok 10400, ThailandBotulinum toxin type A (BoNT-A) injection and micro-focused ultrasound with visualization (MFU-V) are becoming increasingly popular for various esthetic conditions. However, performing MFU-V subsequently to BoNT-A injection may diminish the efficacy of BoNT-A. Previous reports have indicated the impact of various energy-based devices on BoNT-A. Nevertheless, the influence of MFU-V on BoNT-A has yet to be investigated. Thus, this study aims to evaluate the effect of MFU-V on BoNT-A injection and to determine the optimal interval between each treatment. A randomized controlled study was conducted on 15 subjects. Each participant was assigned to receive four sites of intradermal BoNT-A injection on their forehead. Following BoNT-A injection, these locations were randomized to receive either no MFU-V treatment or further treatment with MFU-V (superficial transducer, 10.0 MHz, 1.5 mm) on the same day, Day 7, or Day 14. On Day 28 following injection, the anhidrosis area was measured using the iodine starch test to objectively evaluate the result. In comparison to the control site (1.10 cm<sup>2</sup>), the anhidrotic area was significantly smaller in all MFU-V treated sites (0.74 cm<sup>2</sup> in immediate MFU-V treatment, <i>p</i> < 0.001; 0.90 cm<sup>2</sup> in MFU-V Day 7, <i>p</i> = 0.005; 0.93 cm<sup>2</sup> in MFU-V Day 14, <i>p</i> = 0.021). There were no serious and esthetic complications reported in our study. <b>In conclusion,</b> MFU-V with a superficial depth transducer significantly reduced the efficacy of intradermal BoNT-A injection, especially within two weeks following BoNT-A injection. After BoNT-A injection, we recommend MFU-V treatment should be avoided for at least two weeks. Further study is required to evaluate the optimal interval between these two treatments.https://www.mdpi.com/2072-6651/17/3/147hyperhidrosisneuromodulatorneurotoxintighteningwrinkle
spellingShingle Sarawin Harnchoowong
Natthachat Jurairattanaporn
Vasanop Vachiramon
The Effect of Micro-Focused Ultrasound Treatment on Intradermal Botulinum Toxin Type A Injection
Toxins
hyperhidrosis
neuromodulator
neurotoxin
tightening
wrinkle
title The Effect of Micro-Focused Ultrasound Treatment on Intradermal Botulinum Toxin Type A Injection
title_full The Effect of Micro-Focused Ultrasound Treatment on Intradermal Botulinum Toxin Type A Injection
title_fullStr The Effect of Micro-Focused Ultrasound Treatment on Intradermal Botulinum Toxin Type A Injection
title_full_unstemmed The Effect of Micro-Focused Ultrasound Treatment on Intradermal Botulinum Toxin Type A Injection
title_short The Effect of Micro-Focused Ultrasound Treatment on Intradermal Botulinum Toxin Type A Injection
title_sort effect of micro focused ultrasound treatment on intradermal botulinum toxin type a injection
topic hyperhidrosis
neuromodulator
neurotoxin
tightening
wrinkle
url https://www.mdpi.com/2072-6651/17/3/147
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