[Botulinumtoxin A in simultaneous combination with lasers and energy-based devices (EBD)]

Skin rejuvenation requires a combination of different treatment modalities, including lasers, intense pulsed light (IPL), radiofrequency, high-intensity focused ultrasound (HIFU), botulinum toxin, and fillers. A combined approach is considered optimal; however, same-day combination treatments are generally avoided, and laser treatments are usually performed prior to injection of fillers or toxin due to concerns that light-based energy may inactivate or degrade these substances.

The aim of this publication is to provide an overview of the literature on the use of combination therapies and the resulting treatment recommendations.

The literature review identified numerous studies on combination therapies in which lasers and energy-based devices (EBDs) were applied on the same day as injections of botulinum toxin A.

The identified studies consistently reported clinical improvement and no reduction in the efficacy of botulinum toxin A when administered in close temporal proximity, except in the case of fractional radiofrequency microneedling and HIFU.