The Efficacy and Safety of Fractional CO₂ Laser Combined with Topical Type A Botulinum Toxin for Facial Rejuvenation: A Randomized Controlled Split-Face Study.

Jie Zhu,Xi Ji,Juan Liu,Bing-Rong Zhou,Dan Luo,Min Li,Jia-An Zhang,Xiao-E Chen

doi:10.1155/2016/3853754

Abstract

Objective. We evaluated synergistic efficacy and safety of combined topical application of Botulinum Toxin Type A (BTX-A) with fractional CO2 laser for facial rejuvenation. Methods. Twenty female subjects were included for this split-face comparative study. One side of each subject's cheek was treated with fractional CO2 plus saline solution, and the other side was treated with fractional CO2 laser plus topical application of BTX-A. Patients received one session of treatment and evaluations were done at baseline, one, four, and twelve weeks after treatment. The outcome assessments included subjective satisfaction scale; blinded clinical assessment; and the biophysical parameters of roughness, elasticity, skin hydration, transepidermal water loss (TEWL), and the erythema and melanin index. Results. BTX-A combined with fractional CO2 laser sides showed higher physician's global assessment score, subject satisfaction score, roughness, skin hydration, and skin elasticity compared to that of fractional CO2 plus saline solution side at 12 weeks after treatment. TEWL and erythema and melanin index showed no significant differences between two sides at baseline, one, four, and twelve weeks after treatment. Conclusion. Topical application of BTX-A could enhance the rejuvenation effect of fractional CO2 laser.

Highlights

Fractional CO2 laser has been considered as the gold standard for skin rejuvenation [1]
Regarding erythema and melanin index, there are no significant differences between Botulinum Toxin Type A (BTX-A) side and saline solution control side up to 12 weeks after laser treatment in all subjects
There are not any significant differences between the two sides in regard to the pain score, edema score, duration of crusting, and duration of erythema, which verify that adjuvant BTXA treatment may not help promote the recovery of laserdamaged skin and decrease downtime

Summary

Introduction

Fractional CO2 laser has been considered as the gold standard for skin rejuvenation [1]. When it is used for facial rejuvenation, it often requires multiple therapy sessions which will be a kind of psychological and economic burden for the patients. How to reduce adverse reactions of fractional CO2 laser, while enhancing its rejuvenation effect, has become one hot topic in dermatological research field. BTX-A can result in muscle fiber atrophy and subsequent clinical flaccid paralysis [4]. Some physicians have observed a facelifting effect after intradermal injection of BTX-A to the mid and lower face [6, 7]; the underlying mechanisms still remain unclear. In 2014, our research group further confirmed the direct antiphotoaging

Methods

Results

Conclusion