The licence for Botox (botulinum toxin type A) has been extended to include temporary improvement in the appearance of moderate to severe crow's feet seen at maximum smile, when these have an important psychological impact.1
Botox is reconstituted to a concentration of 50 units/1.5ml, and three 0.1ml injections are given into the lateral orbicularis oculi muscle on each side, for a total dose of 24 units. For patients who also have glabellar lines causing psychological effects, these may be treated at the same time.1
Improvement generally occurs within one week after treatment and lasts for up to four months. Treatment intervals should not be less than three months.1
1. Botox Summary of Product Characteristics, January 2014.