Our recent study on ‘Botulinum Type B; pH change reduces injection pain, retains efficacy’ has just be published in the Journal of Dermatologic Surgery.
Philippa and I studied several patients who had become resistant to all three Type A toxins (Botox is one Type A). They all responded to Type B toxin.
Type B toxin injection is normally very painful because it comes as an acidic solution. We proved on four patients we could minimise this pain by special dilution to reduce acid levels.
At the Cranley Clinic we now routinely use a Botulinum Toxin (Xeomin) without any excess protein to minimise patients developing resistance.
When we inject with Type B toxin we always adjust the pH to make to almost painless.