Prevalence of periocular depigmentation after repeated botulinum toxin A injections in African American patients

Botulinum toxin A (Botox), administered by subcutaneous or intramuscular in jection, is the most commonly used and most successful medication for many craniocervical dystonias. Although some patients experience side effects re lated to the neuroparalytic action of the medication, these side effects ar e temporary. In 1996, permanent periocular cutaneous depigmentation was rep orted in three white patients after repeated Botox injections suggesting th at loss or alteration of melanin pigment might be a permanent side effect o f long-term Botox injections. The authors examined and photographed 26 Afri can American patients who were receiving periocular Botox injections for he mifacial spasm and essential blepharospasm. The authors found no evidence o f periocular cutaneous depigmentation in any of these patients.