{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T22:29:13Z","timestamp":1779316153948,"version":"3.51.4"},"reference-count":49,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T00:00:00Z","timestamp":1760313600000},"content-version":"vor","delay-in-days":12,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Cosmetic Dermatology"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The demand for botulinum toxin A (BTX\u2010A) cosmetic treatments is growing among individuals with skin of color, primarily due to increased cultural acceptance, social media influence, and patient awareness. However, there remains a lack of standardized, evidence\u2010based guidance on the use of BTX\u2010A in these populations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To develop consensus\u2010based clinical recommendations on aesthetic botulinum toxin injection practices in patients with skin of color.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A modified e\u2010Delphi method was conducted with 10 board\u2010certified dermatologists specializing in cosmetic dermatology. Inclusion criteria required \u2265\u20095\u2009years of experience and publications, or teaching activity in BTX\u2010A use. Two e\u2010Delphi rounds evaluated 29 evidence\u2010based statements. Consensus was defined as \u2265\u200970% agreement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Consensus was achieved on 22 statements. Key recommendations included initiating BTX\u2010A treatments at ages 30\u201335, dosing 40\u201360\u2009IU for the upper face, with 16\u201320\u2009week intervals, using 2\u2009mL of saline reconstitution per 100\u2009IU, and employing 30\u2010gauge insulin syringes. Topical EMLA was collectively agreed upon for pain control. While several technical aspects, such as injection depth and under\u2010eye applications, remained inconclusive, participants decided on key practical precautions, including posttreatment activity restrictions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>These consensus\u2010based recommendations can standardize, make BTX\u2010A injections safe and effective for skin of color patients, supporting more uniform and comparable treatment results.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jocd.70492","type":"journal-article","created":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T01:48:19Z","timestamp":1760406499000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["<scp>BOTME<\/scp>\n                    Study: A National e\u2010Delphi Study on the Use of\n                    <scp>Botulinum<\/scp>\n                    Toxin for Aesthetic Treatment of Middle Easterners"],"prefix":"10.1111","volume":"24","author":[{"given":"Mohammed","family":"Al\u2010Haddab","sequence":"first","affiliation":[{"name":"Department of Dermatology College of Medicine, King Saud University  Riyadh Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammed","family":"AlFada","sequence":"additional","affiliation":[{"name":"Department of Dermatology College of Medicine, King Saud University  Riyadh Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasser","family":"Alqubaisy","sequence":"additional","affiliation":[{"name":"Department of Dermatology Prince Sultan Medical Military City  Riyadh Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naif","family":"Alshahrani","sequence":"additional","affiliation":[{"name":"Department of Dermatology College of Medicine, Prince Sattam Bin Abdulaziz University  Al\u2010Kharj Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammed A.","family":"Alsufyani","sequence":"additional","affiliation":[{"name":"Department of Dermatology Prince Sultan Medical Military City  Riyadh Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdulaziz","family":"Madani","sequence":"additional","affiliation":[{"name":"Department of Dermatology College of Medicine, King Saud University  Riyadh Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdullah","family":"Aleisa","sequence":"additional","affiliation":[{"name":"Department of Dermatology College of Medicine, King Saud University  Riyadh Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Homaid Obidullah","family":"Alotaibi","sequence":"additional","affiliation":[{"name":"Department of Dermatology King Faisal Hospital  Makkah Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdulmajeed","family":"Alajlan","sequence":"additional","affiliation":[{"name":"Department of Dermatology College of Medicine, King Saud University  Riyadh Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Norah","family":"Alsubait","sequence":"additional","affiliation":[{"name":"Department of Dermatology Aliman General Hospital  Riyadh Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0334-6547","authenticated-orcid":false,"given":"Fatimah J.","family":"Al Muqarrab","sequence":"additional","affiliation":[{"name":"Department of Dermatology College of Medicine, King Saud University  Riyadh Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,10,13]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.2147\/CCID.S410621"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-323-83144-4.00026-5"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1055\/s\u20100029\u20101224793"},{"key":"e_1_2_11_5_1","unstructured":"American Society of Plastic Surgeons \u201cBriefing Paper: Plastic Surgery for Ethnic Patients \u201dhttps:\/\/www.plasticsurgery.org\/news\/briefing\u2010papers\/briefing\u2010paper\u2010plastic\u2010surgery\u2010for\u2010ethnic\u2010patients."},{"key":"e_1_2_11_6_1","first-page":"360","article-title":"Cosmetic Concerns in Skin of Color, Part 1","volume":"22","author":"Marcelyn Coley A. A.","year":"2009","journal-title":"Cosmetic Dermatology"},{"key":"e_1_2_11_7_1","volume-title":"Taylor and Kelly's Dermatology for Skin of Color","author":"Taylor S. C.","year":"2016"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00403\u2010022\u201002507\u2010z"},{"issue":"6","key":"e_1_2_11_9_1","first-page":"435","article-title":"Defining Skin of Color","volume":"69","author":"Taylor S. C.","year":"2002","journal-title":"Cutis"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/DSS.0000000000004313"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.5662\/wjm.v11.i4.116"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2013.12.002"},{"key":"e_1_2_11_13_1","volume-title":"Taylor and Kelly's Dermatology for Skin of Color","author":"Callender V. D.","year":"2016"},{"issue":"1","key":"e_1_2_11_14_1","first-page":"31","article-title":"Aging Differences in Ethnic Skin","volume":"9","author":"Vashi N. A.","year":"2016","journal-title":"Journal of Clinical and Aesthetic Dermatology"},{"issue":"6","key":"e_1_2_11_15_1","first-page":"s77","article-title":"Ethnicity and Aging Skin","volume":"16","author":"Alexis A. F.","year":"2017","journal-title":"Journal of Drugs in Dermatology"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102133.1990.tb16119.x"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-08-092480-9.50006-X"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/DSS.0000000000002237"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1055\/s\u20100030\u20101253501"},{"issue":"9","key":"e_1_2_11_20_1","first-page":"858","article-title":"Understanding the Female African American Facial Aesthetic Patient","volume":"18","author":"Alexis A.","year":"2019","journal-title":"Journal of Drugs in Dermatology"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/GOX.0000000000002220"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1093\/asj\/sjac246"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/DSS.0000000000002864"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1473\u20102165.2007.00325.x"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/jocd.15640"},{"key":"e_1_2_11_26_1","volume-title":"Procedures in Cosmetic Dermatology: Cosmetic Procedures in Skin of Color","author":"Chan H. H. L.","year":"2024"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/DSS.0000000000001045"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/GOX.0000000000000507"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.2165\/00128071\u2010200304100\u201000005"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-323-83144-4.00015-0"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1055\/s\u20102007\u2010967748"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1097\/PSN.0000000000000279"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.20517\/2347\u20109264.2018.39"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524\u20104725.2009.01063.x"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.1067\/mjd.2000.106506"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.1080\/02844319950159677"},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0007\u20101226(03)00016\u2010X"},{"issue":"4","key":"e_1_2_11_38_1","first-page":"350","article-title":"Efficacy and Safety of Incobotulinumtoxin A for the Correction of Glabellar Lines Among Patients With Skin Types IV to VI","volume":"14","author":"Jackson B. A.","year":"2015","journal-title":"Journal of Drugs in Dermatology"},{"key":"e_1_2_11_39_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524\u20104725.2012.02551.x"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.5005\/jp-journals-10024-2926"},{"key":"e_1_2_11_41_1","doi-asserted-by":"publisher","DOI":"10.1053\/mda.2001.25138"},{"key":"e_1_2_11_42_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12035\u2010013\u20108423\u20109"},{"key":"e_1_2_11_43_1","doi-asserted-by":"publisher","DOI":"10.1002\/1531\u20108257(199903)14:2<307::aid\u2010mds1016>3.0.co;2\u20103"},{"key":"e_1_2_11_44_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0012162203000380"},{"key":"e_1_2_11_45_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000038215"},{"key":"e_1_2_11_46_1","doi-asserted-by":"publisher","DOI":"10.1097\/PSN.0000000000000172"},{"issue":"3","key":"e_1_2_11_47_1","first-page":"29","article-title":"The Use of a Contact Cooling Device to Reduce Pain and Ecchymosis Associated With Dermal Filler Injections","volume":"3","author":"Nestor M. S.","year":"2010","journal-title":"Journal of Clinical and Aesthetic Dermatology"},{"key":"e_1_2_11_48_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e31819c18e7"},{"key":"e_1_2_11_49_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbrc.2012.11.048"},{"key":"e_1_2_11_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3565(25)31908-7"}],"container-title":["Journal of Cosmetic Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jocd.70492","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T02:18:22Z","timestamp":1764641902000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jocd.70492"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10]]},"references-count":49,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2025,10]]}},"alternative-id":["10.1111\/jocd.70492"],"URL":"https:\/\/doi.org\/10.1111\/jocd.70492","archive":["Portico"],"relation":{},"ISSN":["1473-2130","1473-2165"],"issn-type":[{"value":"1473-2130","type":"print"},{"value":"1473-2165","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10]]},"assertion":[{"value":"2025-06-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-27","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-13","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70492"}}