*All the authors are affiliated with the Department of Dermatology, Henry Ford Hospital, Detroit, Michigan.
Dermatol Surg. 2015 Jan;41 Suppl 1:S75-81. doi: 10.1097/01.DSS.0000452642.83894.ab.
Botulinum toxin Type A (BoNT A) for the treatment of facial wrinkles is delivered through local injection. We previously demonstrated that topical surface application of BoNT A has negligible cutaneous bioavailability and is not effective in treating wrinkles.
To determine the effect of BoNT A solution applied topically on the skin surface immediately after ablative fractional CO2 laser treatment.
We conducted a randomized controlled trial for patients with periorbital wrinkles (crow's feet) (n = 10). Treatment was performed on both sides of the face with fractional ablative CO2 laser followed by the application of topical solutions of BoNT A on one side and normal saline as control on the other side. Pretreatment assessment was performed, and at 1 and 4 weeks after treatment.
There was a clinically significant greater degree of improvement in wrinkles after treatment with CO2 laser, on the topically applied BoNT A side. Also, the difference between the 2 treatment types (laser followed by topical BoNT A vs laser followed by saline) at 1 week and at 1 month was statistically significant.
Topically, noninjectable form of BoNT A applied on the surface of the skin after ablative fractional CO2 laser is effective in the treatment of lateral periorbital wrinkles.
肉毒毒素 A 型（BoNT A）用于治疗面部皱纹是通过局部注射给药。我们之前的研究表明，BoNT A 的局部表面应用具有可忽略的皮肤生物利用度，并且对治疗皱纹无效。
确定在消融性 CO2 激光治疗后立即将 BoNT A 溶液局部应用于皮肤表面的效果。
我们对 10 例眶周皱纹（鱼尾纹）患者进行了一项随机对照试验。在面部两侧进行分数性消融性 CO2 激光治疗，然后在一侧应用 BoNT A 局部溶液，另一侧应用生理盐水作为对照。在治疗前进行评估，并在治疗后 1 周和 4 周进行评估。
在 CO2 激光治疗后，用 BoNT A 局部涂抹的一侧皱纹有明显的改善，且差异具有统计学意义。此外，两种治疗方式（激光后局部涂抹 BoNT A 与激光后生理盐水）在 1 周和 1 个月时的差异均具有统计学意义。
在消融性 CO2 激光后，将非注射型 BoNT A 局部应用于皮肤表面对治疗外侧眶周皱纹有效。
