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Research Letter
December 15, 2008

Intrafollicular Orifice Injection Technique for Botulinum Toxin Type A

Arch Dermatol. 2008;144(12):1657-1658. doi:10.1001/archderm.144.12.1657

Botulinum toxin type A (Botox; Allergan Inc, Irvine, California) injection for facial enhancement is the most common cosmetic procedure performed in the United States.1-3 Patient comfort and pain control is important for patient satisfaction and for patient retention after the cosmetic procedure. The use of preservative-containing isotonic sodium chloride solution (normal saline), topical anesthesia, and cryoanalgesia prior to injection of botulinum toxin type A or B decreases patient discomfort, as does the use of 32-gauge rather than 30-gauge needles.4-6 Since intrafollicular orifice injection (IFOI) decreases the pain of local anesthesia,7 we extend the technique to the injection of botulinum toxin into the glabellar region. In the present study, we compared the IFOI technique with nonfollicular traditional injection (TI) with regard to patient pain perception.