This chapter will discuss the use of botulinum toxin type A (BTX-A) in dermatology for the treatment of pain, and to improve the appearance and presentation of female breasts.

Since BTX-A was first reported to be useful for the reduction in the pain of spasmodic torticollis in 19851, the number of references in Medline™ to ‘botulinum’ and ‘pain’ have been growing at an increasing rate (Figure 7.1)—by mid-June 2005 there were over 580 references. The list of painful conditions reported to respond well to BTX-A is also growing, and now includes some dermatologic conditions. This chapter will focus on the treatment of postherpetic neuralgia (PHN), painful scars, and reflex sympathetic dystrophy.