Scottsdale – The July issue of Plastic and Reconstructive Surgery, the Official Journal of the American Society of Plastic Surgeons reports on a novel use of Botox for the treatment of patients with Raynaud’s phenomenon who have chronic pain and ulcerations of their digits.

Patients with Raynaud’s phenomenon can have unrelenting pain that frequently leads to dysfunction and disuse, rendering the patient debilitated and depressed. Pharmacologic blood vessel dilators and surgical options offer variable benefits. Outcomes of symptomatic patients treated with botulinum toxin type A (Botox) injections for Raynaud’s phenomenon are presented after a retrospective study focused on patient outcomes when performed on 19 patients diagnosed with Raynaud’s phenomenon.

All patients in the study, suffered from chronic ischemic hand pain. All patients had vascular studies to rule out occlusive disease. Fifty to 100 units of Botox were injected into the palm around each involved neurovascular bundle. Preinjection and postinjection laser Doppler scanning was performed on most patients to measure blood flow and measure differences.

Sixteen of 19 patients (84 percent) reported pain reduction at rest. Thirteen patients reported immediate relief. Three reported more gradual pain reduction over 1 to 2 months. Three patients had no or minimal pain relief. Tissue perfusion results demonstrated a marked change in blood flow to the digits. All patients with chronic finger ulcers healed within 60 days. Sixty three percent of patients remained pain-free for 13 to 59 months after a single injection. Four patients (21 percent) required repeated injections because of recurrent pain.

In this particular study, the researchers make a case for the use of Botox in the treatment of vascular dysfunction is patients with Raynaud’s phenomenon. Although the mechanism is unknown, Botox injections, yielded a distinct improvement in perfusion and reduction of pain for these patients. Unfortunately,  with such a small study groupd, continued research is required to obtain more specific and reliable treatment for Raynaud’s patients.