Treatment of forehead/glabellar rhytide complex with combination botulinum toxin a and hyaluronic acid versus botulinum toxin a injection alone: a split-face, rater-blinded, randomized control trial Journal Article

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Authors: Dubina, M.; Tung, R; Bolotin, D.; Mahoney, A. M.; Tayebi, B.; Sato, M.; Mulinari-Brenner, F.; Jones, T; West, D. P.; Poon, E; Nodzenski, M.; Alam, M
Article Title: Treatment of forehead/glabellar rhytide complex with combination botulinum toxin a and hyaluronic acid versus botulinum toxin a injection alone: a split-face, rater-blinded, randomized control trial
Abstract: BACKGROUND: Forehead and glabella rhytides are treated mostly with neurotoxins, although some practitioners prefer the concurrent use of fillers. It has been suggested that combination treatments can result in a better overall improvement. AIMS: To compare the safety and effectiveness of treatment of forehead and glabellar lines with botulinum toxin A alone versus botulinum toxin A and filler. METHODS: Split-face, randomized control trial. Twenty subjects with forehead/glabellar rhytide complex (static and dynamic creases) enrolled. Subjects were randomized and injected with botulinum toxin alone on one side of the forehead/glabella and hyaluronic acid filler followed by botulinum toxin on the other side. Blinded ratings were obtained to assess the effectiveness of treatment for static and dynamic rhytides, respectively, at 2-week, 6-week, 3-month, and 6-month follow-up visits. Subjects performed a self-evaluation at the end of the study. Adverse events were recorded. RESULTS: Ratings of both treatments showed comparable efficacy, with 100% of subjects experiencing improvement from baseline regardless of treatment type at weeks 2, 6, and 12. Combination treatment produced longer-lasting results in dynamic forehead wrinkles, and greater static and dynamic wrinkle reduction in the glabella at week 24. Subject self-evaluations showed that both treatments were effective, with a nominal preference for combination treatment. CONCLUSIONS: Glabella and forehead lines can be effectively and safely reduced with neurotoxin alone as well as neurotoxin in combination with fillers. Combination treatment may provide a slightly better cumulative benefit and also increase the persistence of effect.
Journal Title: Journal of cosmetic dermatology
Volume: 12
Issue: 4
ISSN: 1473-2165; 1473-2130
Publisher: Wiley Periodicals, Inc  
Journal Place: England
Date Published: 2013
Start Page: 261
End Page: 266
Language: eng
DOI/URL:

10.1111/jocd.12059

10.1111/jocd.12059
Notes: CI: (c) 2013; JID: 101130964; OTO: NOTNLM; 2013/08/11 [accepted]; ppublish