Carbon-Assisted Q-Switched Nd:YAG Laser and Microneedling Delivery of Botulinum Toxin: A Prospective Pilot Study

Background: Carbon-assisted, Q-switched, neodymium-doped yttrium-aluminum-garnet laser treatment consists of applying a topical carbon suspension all over the face, followed by irradiation with a Q-switched 1064-nm neodymium-doped yttrium-aluminum-garnet laser. The delivery of multiple microdroplets of dilute onabotulinum toxin type A into the dermis has been investigated as a tool for facial rejuvenation. The aim of this study was to assess the effectiveness of the combined treatment with botulinum toxin and carbon peel laser (performed with a standardized technique) in patients with seborrhea, dilated pores, and wrinkles, and to demonstrate its benefits in improving the overall skin aspect.

Methods: Patients enrolled in this prospective pilot study underwent 3 sessions of the combined treatment carried out 3 months apart. To evaluate the improvement of skin texture, wrinkles, dilated pores, and acne lesions, the Fitzpatrick Wrinkle Assessment Scale, the Physician Global Aesthetic Improvement Scale, a photographic scale for the pore assessment, and the Investigator Global Assessment of Acne scale were used. The FACE-Q was also administered to assess patient satisfaction. The scores obtained were compared using a paired t test.

Results: Twenty patients were recruited. The differences between pretreatment and posttreatment scores were statistically significant ( P < 0.05) on the Fitzpatrick Wrinkle Assessment Scale, Physician Global Aesthetic Improvement Scale, Investigator Global Assessment of Acne scale, FACE-Q, and photographic scale for the pore assessment.

Conclusions: This combined protocol could be considered as a useful tool to treat skin flaws that affect texture, microroughness, and seborrhea and to reduce the size of enlarged pores. Its versatility allows for customized treatment with minimal discomfort to patients.

Clinical Question/level Of Evidence: Therapeutic, IV.