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

[BACKGROUND] 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.

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

[METHODS] 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.

[CONCLUSION] 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.