PHOENIX, ARIZ. Adding Botox therapy to cosmetic dermatologic treatments can "extend the results for virtually everything we do," Jean Carruthers, M.D., said at a clinical dermatology conference sponsored by Medicis.
Clinical studies have already shown that combining botulinum toxin type A with broadband light therapy and with nonanimal stabilized hyaluronic acid can produce better results than a single therapy, reported Dr. Carruthers, an ophthalmology professor at the University of British Columbia, Vancouver.
"It makes so much sense to use them together," she said of Botox and Restylane, a nonanimal stabilized hyaluronic acid filler approved for use in the United States. "Botox halts active frown, and Restylane helps the dermis."
Dr. Carruthers cited a prospective study she conducted with her husband Alaistair Carruthers, B.M., of the same university. They randomized 38 adult females with moderate to severe glabellar wrinkles into two cohorts for a comparison of Restylane therapy alone with Restylane plus Botox.
The investigators reported that the women given both treatments "showed a better response both at rest and on maximal frown." The combination treatment also lasted longer. Median time to preinjection furrow status was 32 weeks for the combination patients, compared with 18 weeks for those treated only with the filler (Dermatol. Surg. 2003;29:8029).
In another study, they randomized 30 women with moderate to severe crow's feet to two groups: one treated only with broadband light therapy and the other to light therapy plus Botox treatment. For this experiment they used Intense Pulsed Light from Lumenis Ltd. of Yokneam, Israel.
The Carruthers reported that all patients showed improvement when their faces were at rest and smiling, but the patients given both treatments improved more. Skin biopsies revealed an increase in dermal collagen for both groups. The researchers also reported improvements in lentigines, telangiectasia, and skin texture (Dermatol. Surg. 2004;30:3556).
Dr. Carruthers called the synergy with the light system exciting. "Does IPL [intense pulsed light] stimulate new dermal collagen deposition?" she asked. "Does Botox stimulate new collagen formation in the dermis? Is it just IPL, or is Botox additive?"
Dr. Carruthers' commercial disclosures include Allergan, maker of Botox; Medicis Pharmaceuticals, distributor of Restylane; and Lumenis. She said she is a consultant to and investor in Allergan.