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Case Reports
. 2022 Aug 31;14(2):253-256.
doi: 10.1159/000525937. eCollection 2022 May-Aug.

Persistent Facial Blanching after Botulinum Toxin Injection

Fouad Mitri  1 , Katharina Anna Kälber  1 , Alexander H Enk  1 , Ferdinand Toberer  1
Affiliations
Case Reports

Persistent Facial Blanching after Botulinum Toxin Injection

Fouad Mitri et al. Case Rep Dermatol. .

Abstract

We report the case of a 38-year-old male patient who presented with blanching of the face after strenuous exercise or physical exertion. The symptoms regressed in a relaxed state. Three years before presentation, he underwent botulinum toxin injections in the affected areas of the face. Facial blanching is a rare side effect of botulinum toxin injection. The postulated pathophysiology involves different transmitters mainly acetylcholine as well as co-transmitters implicated in vasodilation. Usually, facial blanching resolves shortly after waning of the botulinum toxin. However, in our case, the symptoms persisted for a longer time. Till date, therapy options for post-botulinum facial blanching are lacking, mainly due to the temporary aspect of the disease.

Keywords: Botulinum toxin; Facial blanching; Vasodilation.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Fig. 1
Fig. 1
aLateral view of the right cheek showing whitish macules on a rather hyperemic background.bFrontal view showing the patient's forehead after bowing his head several times.
See this image and copyright information in PMC

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