Prolonged Antipruritic Effect of Botulinum Toxin Type A on Cowhage-induced Itch: A Randomized, Single-blind, Placebo-controlled Trial

Authors

  • Leigh A. Nattkemper Department of Dermatology, Miami Itch Center, University of Miami Miller School of Medicine, Miami, FL, USA
  • Ashley Vander Does Department of Dermatology, Miami Itch Center, University of Miami Miller School of Medicine, Miami, FL, USA
  • Carolyn M. Stull Department of Dermatology, Temple University Lewis Katz School of Medicine, Philadelphia, PA, USA
  • Michael J. Lavery Department of Dermatology, Temple University Lewis Katz School of Medicine, Philadelphia, PA, USA
  • Rodrigo Valdes-Rodriguez Department of Dermatology, Temple University Lewis Katz School of Medicine, Philadelphia, PA, USA
  • Marlene McGregory Department of Dermatology, Temple University Lewis Katz School of Medicine, Philadelphia, PA, USA
  • Yiong Huak Chan Biostatistics Unit, National University of Singapore Lon Lin School of Medicine, Singapore, Singapore
  • Gil Yosipovitch Department of Dermatology, Miami Itch Center, University of Miami Miller School of Medicine, Miami, FL, USA

DOI:

https://doi.org/10.2340/actadv.v103.6581

Keywords:

antipruritic, itch, cowhage, botulinum toxin

Abstract

Botulinum toxin type A (Botox®) is thought to have antipruritic effects through inhibition of pruritic factors, including acetylcholine, substance P, and glutamate. The aim of this randomized, single-blind, placebo-controlled trial was to test the effect of botulinum toxin type A on cowhage, a non-histaminergic model for chronic itch. Botulinum toxin type A was injected into the arm of 35 healthy subjects, with a saline control injected into the contralateral arm. Thermal sensory parameters (warmth and heat thresholds and heat pain intensity) and itch intensity after cowhage application were examined on test areas. Botulinum toxin type A reduced itch intensity, overall perceived itch (area under the curve (AUC); percentage change from baseline), and peak itch intensity compared with the control at 1 week, 1 month, and 3 months. Botulinum toxin type A had no effect on thermal thresholds or heat pain intensity. In conclusion, botulinum toxin type A reduced cowhage itch for at least 3 months, which suggests that botulinum toxin type A is a potential long-lasting treatment for localized, non-histaminergic itch.

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Additional Files

Published

2023-08-16

How to Cite

Nattkemper, L. A., Vander Does, A., Stull, C. M., Lavery, M. J., Valdes-Rodriguez, R., McGregory, M., Chan, Y. H., & Yosipovitch, G. (2023). Prolonged Antipruritic Effect of Botulinum Toxin Type A on Cowhage-induced Itch: A Randomized, Single-blind, Placebo-controlled Trial. Acta Dermato-Venereologica, 103, adv6581. https://doi.org/10.2340/actadv.v103.6581

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