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I know there's been some experimental use of BOTOX for Raynaud phenomenon of the hands. I'm checking into this for myself. Are there any problems or a downside to using BOTOX for this condition?
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BOTOX injections have been used in small studies for the treatment of Raynaud phenomenon. It may turn out to be a less invasive and more effective treatment than surgery for this condition. It works by turning off pain messages sent along tiny nerves in the hands but without having to cut the blood vessels or nerves directly.
The use of BOTOX for this problem is still considered "off-label" and experimental. Off label means the drug is used for something other than what it was intended for. The Food and Drug Administration (FDA) has not approved the use of BOTOX for Raynaud phenomenon.
The treatment is effective though and that's why it's used for patients who have not responded well to other conservative measures and/or who have now developed finger ulcers. The risk of gangrene and amputation is too high to just let the problem go untreated. BOTOX works because it delivers a toxin to the body fluid around the nerves and blood vessels.
Except for some local pain where the needle is inserted, this treatment has very few (if any) negative side effects. Injections can be repeated every four-to-six months (that's about how long the effects last). Painful symptoms are decreased or gone and hand function is much better. But the effects may not last or provide a long-term (permanent) solution. The long-term effects of BOTOX injections for Raynaud phenomenon have not been investigated or reported yet either.
There are some patients who may not be good candidates for this type of approach for their Raynaud condition. For example, if they have tried BOTOX before and didn't tolerate it well or got no results, then a second series of injections isn't likely to help either. If the disease is too far progressed and there's no hope the blood vessels can be repaired, then BOTOX may not be a good idea.
Patients considering BOTOX injections for Raynaud phenomenon should be warned of possible adverse effects of this treatment. Skin infections, inability for the skin to cool itself by sweating (called anhydrosis), and muscle paralysis contributing to hand weakness have been reported.
For many patients hampered by Raynaud phenomenon, a minimally invasive treatment approach may be a welcome option. With good pain control providing improved hand function, BOTOX may be worth taking the chance of potential side effects.
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