A-Z Toxins Administration Guide

Antiwrinkle injections have become one of the most popular treatments for those looking to maintain a youthful appearance. With this increase in demand, it’s more important than ever for practitioners to have a comprehensive understanding of the toxins they’re using – especially when deciding which toxin is most suited to their clinic and their clients.

This guide will cover popular toxins and answer questions such as ‘How many units of Bocouture for three areas?’, ‘How many Botox units per area?’ and ‘How many Azzalure units are needed?’ to provide you with necessary information about these transformative injectables.

What Are Toxins?

Toxins, or antiwrinkle injections, are innovative botulinum injections used to reduce signs of ageing by relaxing muscles, making the skin appear smoother for a youthful glow and appearance. They work by injecting toxins into muscles to prevent the release of acetylcholine, blocking nerve signals to the muscles and causing them to relax. They can also treat other conditions, such as hyperhidrosis (excessive sweating). However, only Botox and Dysport are licensed for this indication.

Fox Pharma supplies a wide range of antiwrinkle injections, from Azzalure to our newest addition, Letybo. Read our A-Z guide for a breakdown of the toxins we stock.

Alluzience

Alluzience is a prescription-only botulinum toxin injection and the first ready-to-use liquid toxin in the UK. It offers fast results within two to three days, and its effects have been demonstrated for up to six months after injection.

For more information on Alluzience, please visit EMC.

Injection Points

• Glabellar lines (vertical lines between the eyebrows)
• Lateral canthal lines (crow’s feet lines)

Recommended Dosage

The recommended dose is 0.25 ml of solution (50 Speywood units) divided into five injection sites, 0.05 ml of solution (10 Speywood units) administered intramuscularly into each of the five sites: two injections into each corrugator muscle and one into the procerus muscle, near the nasofrontal angle.

Contraindications

• Hypersensitivity to the active substance or any of the excipients.
• Presence of infection at the proposed injection sites.
• Presence of myasthenia gravis, Eaton Lambert Syndrome, or amyotrophic lateral sclerosis.

Azzalure

Azzalure is another prescription-only botulinum toxin injection specifically developed for use in medical aesthetic treatments. It has a quick mode of action, showing results in two to three days and lasting up to four months. Notably, the effects may be significant five months after treatment.

For more information on Azzalure, please visit EMC.

Injection Points

• Glabellar lines (vertical lines between the eyebrows)
• Lateral canthal lines (crow’s feet lines)

Recommended Dosage

• Glabellar Lines–The recommended dose is 50 Speywood units of Azzalure to be divided into five injection sites; 10 Speywood units are to be administered intramuscularly, at right angles to the skin, into each of the five sites: two injections into each corrugator muscle and one into the procerus muscle near the nasofrontal angle.
• Lateral Canthal Lines–The recommended dose per side is 30 Speywood units of Azzalure, to be divided into three injection sites; 10 Speywood units are to be administered intramuscularly into each injection point. Injection should be lateral (20 – 30° angle) to the skin and very superficial. All injection points should be at the external part of the orbicularis oculi muscle and sufficiently far from the orbital rim (approximately 1-2 cm).

Instructions For Reconstitution

• If you dilute a vial of Azzalure 125 Speywood units with 0.63ml of Sodium Chloride 0.9%, you will achieve a concentration of 10 units per 0.05ml.
• If you dilute a vial of Azzalure 125 Speywood units with 1.25ml of Sodium Chloride 0.9% you will achieve a concentration of 10 units per 0.1ml.

Contraindications

• Hypersensitivity to the active substance or to any of the excipients.
• Presence of infection at the proposed injection sites.
• Presence of myasthenia gravis, Eaton Lambert Syndrome, or amyotrophic lateral sclerosis.

Bocouture

Bocouture is the first and only purified botulinum toxin formulation free of complexing proteins, with a molecular weight of only 150kD. This reduces the likelihood of neutralising antibodies forming, even in high doses. It can take up to a week to show desired results, which last up to four months.

For more information on Bocoture, please visit EMC.

Injection Points

• Glabellar lines (vertical lines between the eyebrows)
• Lateral canthal lines (crow’s feet lines)
• Forehead lines

Recommended Dosage

• Glabellar Lines–After reconstitution, a dose of four units is injected into each of the five injection sites: two injections in each corrugator muscle and one injection in the procerus muscle, which corresponds to a standard dose of 20 units. The dose may be increased by the physician to up to 30 units if required by the individual needs of the patients, with at least a three month interval between treatments.
• Crow’s Feet Lines–After reconstitution, four units are injected bilaterally into each of the three injection sites. One injection is placed approximately 1 cm lateral from the bony orbital rim. Each of the other two injections should be placed approximately 1 cm above and below the area of the first injection. The total recommended standard dose per treatment is 12 units per side (overall total dose: 24 units).
• Forehead Lines–The recommended total dose range is 10 to 20 units; a total dose of 10 units to 20 units is injected into the frontalis muscle in five horizontally aligned injection sites at least 2 cm above the orbital rim. A dose of two units, three units, or four units is applied per injection point respectively.

Contraindications

• Hypersensitivity to the active substance or any of the excipients.
• Generalised disorders of muscle activity (e.g. myasthenia gravis, Lambert Eaton Syndrome).
• Infection or inflammation at the proposed injection site.

Botox

Botox is the best-known brand of botulinum toxin, which has been licensed for facial aesthetics for more than 16 years and is produced using a unique manufacturing process. Botox’s potency is measured in units that are not interchangeable with other toxins. The results can begin within a week, lasting three to four months.

For more information on Botox, please visit EMC.

Injection Points

• Glabellar lines (vertical lines between the eyebrows)
• Lateral canthal lines (crow’s feet lines)
• Forehead lines
• Underarms to treat severe hyperhidrosis

Recommended Dosage

• Glabellar Lines–A volume of 0.1 ml (four units) is administered in each of the five injection sites: two injections in each corrugator muscle and one injection in the procerus muscle for a total dose of 20 Units. To reduce the risk of eyelid ptosis, the maximum dose of four units for each injection site as well as the number of injection sites, should not be exceeded.
• Crow’s Feet Lines–A volume of 0.1 ml (four units) is administered in each of the three injection sites per side (total of six injection sites) in the lateral orbicularis oculi muscle, for a total dose of 24 units in a total volume of 0.6 ml (12 units per side).
• For simultaneous treatment with glabellar lines seen at maximum frown, the dose is 24 units for crow’s feet lines seen at maximum smile and 20 units for glabellar lines for a total dose of 44 units in a total volume of 1.1 ml. In order to reduce the risk of eyelid ptosis, the maximum dose of four units for each injection site as well as the number of injection sites, should not be exceeded.

Contraindications

• Known hypersensitivity to botulinum toxin type A or to any of the excipients.
• Presence of infection at the proposed injection site(s).

Dysport

Dysport is a botulinum toxin that is licensed for use on the face for uncontrolled blinking and spasms, but it is not licensed for aesthetic use on the face. It is also licensed for the treatment of hyperhidrosis. For hyperhidrosis, an adequate dosage will suppress sweat secretion for 48 weeks, but injections should not be repeated more frequently than every 12 weeks.

For more information on Dysport, please visit EMC.

Contraindications

• Hypersensitivity to the active substance or to any of the excipients.

Letybo

Letybo is a botulinum toxin injection typically used to treat clients under the age of 75. Results typically appear within two to three days and last three to four months.

Letybo is delivered as a white powder, to be reconstituted as a solution for injection. A single vial contains 50 units of botulinum toxin type A, which is produced by Clostridium botulinum.

For more information on Letybo, please visit EMC.

Injection Points

• Glabellar lines (vertical lines between the eyebrows)

Recommended Dosage

The recommended dose of Letybo is a total of 20 units, divided into five injections of four units each, including two injections in each corrugator supercilii muscle and one injection in the procerus muscle.

Contraindications

• Hypersensitivity to the active substance or to any of the excipients.
• Presence of acute infection or inflammation at the proposed injection sites.
• Generalised disorders of muscle activity such as myasthenia gravis, Lambert Eaton Syndrome, and amyotrophic lateral sclerosis.

Prescribe High-quality Toxins From Fox Pharma

Register with Fox Pharma to purchase antiwrinkle injections for your clients, as well as dermal fillers and more of our aesthetic supplies. Read our blog for more practitioner’s guides and information about our products, or contact us.