GLASS LAB · Medical Aesthetics Evidence Index 303 cells · 19,226 papers · 5,969 top-tier evidence

Wrinkle / Line · Crow's feet lateral canthal

Botulinum toxin a evidence for Crow's feet lateral canthal

B 63.2 / 100 Supported 62 RCT/meta · 13 clinical/observational · 13 case · 172 total
Good evidence · positive conclusion

There is a relatively good level of clinical evidence, and a majority of papers support its effectiveness.

Grade combines the quantity and quality of the research, while direction is a separate signal showing how the papers assess effectiveness.

Includes meta-analysis/SR Median year 2016 Last 5 years 34% Positive results 52% Negative results 11 Korea/Asia 14

Known in Korea as

톡신보톡스제오민디스포트코어톡스주름 보톡스다한증 보톡스디자인 보톡스사각턱 보톡스얼굴전체 톡신

Procedure and brand names vary, but the evidence above applies to the same procedure mechanism.

Key papers

tier1 NivobotulinumtoxinA in the Treatment of Lateral Canthal Lines Alone and With Concurrent Treatment of Glabellar Lines. Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.] · 2025 · PMID 40923599

Abstract summary (English) BACKGROUND: Botulinum neurotoxins in aesthetic medicine require reconstitution, which may cause administration errors. OBJECTIVE: To evaluate liquid nivobotulinumtoxinA treatment of lateral canthal lines (LCL) and glabellar lines (GL). MATERIALS AND METHODS: Participants with moderate-to-severe LCL with/without moderate-to-severe GL were enrolled in 2 double-blind randomized clinical trials.

Journal Article, Randomized Controlled Trial

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tier1 Aesthetic Improvements Over Time: Long-Term Efficacy and Additional Outcomes of IncobotulinumtoxinA in the Simultaneous Treatment of Upper Facial Lines. Journal of cosmetic dermatology · 2025 · PMID 40968493

Abstract summary (English) BACKGROUND/OBJECTIVES: Two Phase III randomized controlled trials were conducted in the US (ULTRA I) and Germany (ULTRA II) to investigate the efficacy of incobotulinumtoxinA for simultaneous treatment of upper facial lines (UFLs: glabellar frown lines [GFLs], horizontal forehead lines [HFLs] and lateral canthal lines [LCLs]). PATIENTS/METHODS: Healthy adults with moderate to severe GFLs, HFLs, and symmetrical LCLs...

Journal Article, Randomized Controlled Trial, Clinical Trial, Phase III, Multicenter Study

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tier1 Efficacy and Durability of the Association of Botox and Skinvive in the Treatment of Moderate/Severe Wrinkles in the Periorbital Region: A Randomized, Controlled, Double-Blind, Split-Face Clinical Study. Journal of cosmetic dermatology · 2025 · PMID 40814769

Abstract summary (English) BACKGROUND: The combined efficacy and durability of botulinum toxin A (BTX) and hyaluronic acid fillers (HA) for canthal wrinkles have not been thoroughly evaluated in randomized clinical trials. AIMS: This study evaluated the efficacy, safety, and durability of the combined treatment protocol of onabotulinumtoxinA and Juvederm Volite VYC-12 (Skinvive) for moderate and severe canthal lines. METHODS: This randomized...

Journal Article, Randomized Controlled Trial

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tier1 Comparison of Two Botulinum Neurotoxin Type A Preparations (Masport and Dysport) for Upper Face Rhytides: A Randomized Clinical Trial. Aesthetic plastic surgery · 2025 · PMID 40410321

Abstract summary (English) BACKGROUND: Botulinum neurotoxin type A has played a key role in the treatment of facial rhytides. We aimed to compare the safety and effectiveness of Masport and Dysport as botulinum toxin type A preparations in the treatment of upper face rhytides. METHODS: A double-blind randomized, clinical trial was conducted on adults with at least mild severity (scale 1) for lateral canthal (crow's feet), glabellar, and...

Journal Article, Randomized Controlled Trial, Comparative Study

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tier1 NivobotulinumtoxinA in the Treatment of Glabellar Lines With or Without Concurrent Treatment of Lateral Canthal Lines in Two Phase 3 Clinical Trials. Aesthetic surgery journal · 2025 · PMID 39587780

Abstract summary (English) BACKGROUND: Botulinum neurotoxins in aesthetic medicine require reconstitution before administration, which may be inconvenient and present errors among injectors. OBJECTIVES: The aim of this study was to evaluate the efficacy and safety of ready-to-use nivobotulinumtoxinA liquid formulation for the treatment of glabellar lines (GL) with or without treatment of lateral canthal lines (LCL). METHODS: Two multicenter,...

Journal Article, Clinical Trial, Phase III, Multicenter Study, Randomized Controlled Trial

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tier1 IncobotulinumtoxinA in the Treatment of Upper Facial Lines: Results From Two Randomized, Double-Blind, Placebo-Controlled, Phase III Studies. Aesthetic surgery journal · 2025 · PMID 39475143

Abstract summary (English) BACKGROUND: Two randomized, double-blind, placebo-controlled, Phase III studies of incobotulinumtoxinA for treating upper facial lines (UFLs; ie, a combination of glabellar frown lines [GFLs], horizontal forehead lines [HFLs], and lateral canthal lines [LCLs]) were conducted in the United States (ULTRA I: NCT04594213) and Germany (ULTRA II: NCT04622254). OBJECTIVES: The aim of this study was to evaluate the safety...

Journal Article, Randomized Controlled Trial, Clinical Trial, Phase III, Multicenter Study

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tier1 Meta-Analysis of Adverse Reactions of Botulinum Toxin A in Facial Rejuvenation Treatment. Aesthetic plastic surgery · 2024 · PMID 39623228

Abstract summary (English) BACKGROUND: Facial rejuvenation is a popular non-surgical treatment, and its treatment safety is of key significance to patients. The purpose of this meta-analysis is to compare the effects of botulinum toxin A and placebo on the occurrence of adverse reactions in facial rejuvenation treatment. OBJECTIVE: According to PRISMA guidelines, a comprehensive search was conducted in Chinese and English databases, and 20...

Journal Article, Meta-Analysis

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tier1 Efficacy and Safety of RelabotulinumtoxinA Liquid Botulinum Toxin in the Treatment of Lateral Canthal Lines: Results From the Phase 3 READY-2 Study. Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.] · 2024 · PMID 39692332

Abstract summary (English) BACKGROUND: RelabotulinumtoxinA (RelaBoNT-A) is a complex-free, ready-to-use, liquid botulinum toxin A. OBJECTIVE: Efficacy/safety of RelaBoNT-A treatment for lateral canthal lines (LCL). METHODS: Randomized adults received RelaBoNT-A (30 U/side; n = 230) or placebo ( n = 73) during a 6-month, double-blind, Ph3 study (Relabotulinumtoxin Aesthetic Development Study-2 [READY-2]).

Journal Article, Randomized Controlled Trial, Clinical Trial, Phase III, Multicenter Study, Research Support, Non-U.S. Gov't

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tier1 OnabotulinumtoxinA in Resistant Depression: A Randomized Trial Comparing Two Facial Injection Sites (OnaDEP Study). Depression and anxiety · 2024 · PMID 40226647

Abstract summary (English) Background: OnabotulinumtoxinA (OnaA) injection in glabella area appears to be a promising treatment for major depression. However, one major concern of placebo-controlled studies on botulinum toxin injections is to ensure adequate blinding. Patients and Methods: In this context, all subjects of this trial received the active product (OnaA).

Journal Article, Randomized Controlled Trial, Comparative Study

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tier1 Long-Term Improvement of Crow's Feet Wrinkles in Combination With Cervicofacial and Temporal Lifting: Review of the Literature. Annals of plastic surgery · 2023 · PMID 38170976

Abstract summary (English) BACKGROUND: The lateral orbital crow's feet area is one for which rejuvenation is most frequently requested by patients. Moreover, lateral canthal wrinkles are a common source of dissatisfaction after rhytidoplasty. Botulinum toxin injection has emerged as a most popular, easy, and effective solution; nevertheless, repeated injections are required periodically for long-term effect.

Journal Article, Systematic Review, Research Support, Non-U.S. Gov't

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Suggested interpretation

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