How to use Myobloc (botulinum toxin type B) for dynamic rhytides?

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Last updated: June 12, 2025View editorial policy

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From the Research

Myobloc (botulinum toxin type B) should be used for dynamic rhytides at a dose of 2500 units, divided among five standardized intramuscular sites, for optimal efficacy and safety, as evidenced by the study published in Dermatologic surgery 1. The use of Myobloc for dynamic rhytides is supported by several studies, including one that demonstrated its effectiveness in treating glabellar rhytides refractory to botulinum toxin type A 1.

  • Typical dosing ranges from 1000-2500 units total, with specific amounts varying by treatment area.
  • The onset of action is typically faster than type A toxins (1-3 days versus 3-7 days), but the duration is shorter (8-10 weeks versus 3-4 months) 2.
  • Myobloc has a lower pH (5.6) than type A toxins, which may cause more injection site pain, and a higher diffusion rate, requiring careful technique to avoid affecting adjacent muscles 3.
  • Practitioners should note that Myobloc's units are not equivalent to Botox units (approximately 50:1 ratio), so dosing calculations must be adjusted accordingly 4. Key considerations for using Myobloc include:
  • Careful patient selection, as it is generally reserved for patients who have developed resistance to type A toxins.
  • Precise injection technique to minimize the risk of adverse effects.
  • Monitoring for potential side effects, such as injection site pain, bruising, and frontal brow tightness 1.

References

Research

Botulinum toxin type B for dynamic glabellar rhytides refractory to botulinum toxin type A.

Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.], 2003

Research

Prospective open-label study of botulinum toxin type B (Myobloc) at doses of 2,400 and 3,000 U for the treatment of glabellar wrinkles.

Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.], 2003

Research

Comparison of botulinum toxin types A and B: a bilateral and double-blind randomized evaluation in the treatment of canthal rhytides.

Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.], 2003

Research

Botulinum toxin type B (MYOBLOC) versus botulinum toxin type A (BOTOX) frontalis study: rate of onset and radius of diffusion.

Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.], 2003

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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