The effect of botulinum toxin type A on full-face intense pulsed light treatment: a randomized, double-blind, split-face study.

Background: Botulinum toxin type A (BTX) is commonly used in combination therapy, and it has been reported that periocular BTX treatment enhances the aesthetic improvements attained with intense pulsed light (IPL).

Objective: The objective was to evaluate if intradermal BTX treatment of the cheeks also enhances the efficacy of IPL.

Methods: Fifteen females enrolled in this prospective, randomized, double-blind, split-face study (14 completed, 1 lost to follow-up). All received standard IPL treatment and were randomly assigned to receive eight 0.1-mL intradermal injections of BTX (BOTOX Cosmetic, Allergan) in one cheek (8 U total dose) and eight injections of saline in the contralateral cheek. Small wrinkles and fine lines, erythema, hyperpigmentation, apparent pore size, skin texture, and overall appearance were evaluated for 8 weeks.

Results: A significantly higher proportion of patients showed improvement in small wrinkles and fine lines with IPL plus BTX than IPL plus saline--93% versus 29% at Week 4 (p=.003). Adjunctive BTX also achieved a greater degree of improvement in erythema (although statistical significance was not achieved). Other efficacy measures showed comparable improvements with both regimens.

Conclusions: The adjunctive use of BTX enhances the improvement in small wrinkles and fine lines, and possibly erythema, achieved with IPL alone.