Headache Relief as a Hidden Goal of Patients Treated with BoNT-A for Facial Wrinkles: a Single-Center Pilot Study

Introduction:
Physicians and patients themselves may not have sufficient knowledge of the correct procedure and are not aware of the risk of treatment failure if the Phase III Research Evaluating Migraine Prophylaxis Therapy protocol for chronic migraine is not followed at appropriate intervals and dosage. We suspect that headache relief may sometimes be a hidden reason for seeking onabotulinumtoxinA injections for wrinkles.

Objective:
This study was to assess whether patients requesting onabotulinumtoxinA treatment for wrinkles would consider headache relief among treatment goals. The second objective of this study was to assess the impact of onabotulinumtoxinA on headaches in patients receiving this treatment for wrinkles.

Material and methods:
This pilot study was conducted among 97 consecutive patients admitted to treat facial wrinkles with onabotulinumtoxinA. A detailed structured medical interview focusing on the headache history was conducted by the treating physician. Every patient was treated with onabotulinumtoxinA at a dose determined by individual anatomical conditions.

Results and conclusions:
Two-thirds of patients had suffered from headaches before starting the treatment of wrinkles with onabotulinumtoxinA. Almost half (45.4%) sought wrinkle reduction, but also valued headache relief (45.4%) or considered it a primary goal (5.2%). Only 26.8% of patients reported definitive headache relief after treatment for wrinkles with onabotulinumtoxinA, and at least 50% reduction in headache frequency was achieved by 18% of individuals. The patients’ awareness of onabotulinumtoxinA migraine treatment was low, and preference for treatment by a neurologist or an aesthetic medicine specialist was insignificant. Aesthetic practitioners should be aware of this possible hidden goal of their patients when treating wrinkles with onabotulinumtoxinA.