Skin cooling before periocular botulinum toxin A injection.

Purpose: To determine if skin cooling decreases the pain associated with periocular botulinum toxin A injections.

Methods: In this prospective study, 14 patients given bilateral periocular injections for blepharospasm or wrinkle reduction were included. Prior to the injections, one side received a skin cooling agent and the other side served as the control. Relative pain scores were recorded to assess the effects of treatment.

Results: The range of pain scores on the noncooled side was 3 to 10 (average, 6.5); scores for the cooled side ranged from 0.5 to 7 (average, 3.6), which represents a 45% reduction in pain score.

Conclusions: In most patients, skin cooling decreases the pain associated with periocular botulinum toxin A injection.