University of Lynchburg DMSc Doctoral Project Assignment Repository

University of Lynchburg DMSc Doctoral Project Assignment Repository




Nancy Reid, MHA, DHSc, PA-C


The quantifiable effectiveness of topical ice before injection of botulinum toxin type A in the cosmetic treatment and reduction of dynamic facial rhytids remains understudied. Botulinum toxin type A is a purified protein, or neurotoxin, produced by the bacteria Clostridium botulinum that blocks acetylcholine receptors, thereby reducing or preventing skeletal muscle contraction. The effectiveness of topical ice prior to botulinum toxin injection will be studied because intramuscular injections can cause pain, soreness, and discomfort. Ice is an example of a nonpharmacologic method of easing pain. The technique involves healthcare practitioners applying topical ice for several seconds before injection. Application of topical ice is cost-effective and adjuvant to typical technical pain management, which is often otherwise topical lidocaine preparations that come with potential side effects.1 Furthermore, the ice method does not lead to significant complications when utilized. The study concludes that topical ice does have a significant short-term pain-relieving effect prior to injection; however, more comparison studies of ice versus topical lidocaine need to be performed.


Available when accessing via a campus IP address or logged in with a University of Lynchburg email address.

Off-campus users can also use 'Off-campus Download' button above for access.