Further Enhancement of Facial Appearance With a Hydroquinone Skin Care System Plus Tretinoin in Patients Previously Treated With Botulinum Toxin Type A

Abstract

Adjunctive use of the HQ system plus tretinoin can further enhance the improvements in facial appearance attained with BoNT-A. Applying the HQ system plus tretinoin offers multiple clinical benefits over standard skin care, including significantly greater improvements in fine lines/wrinkles and hyperpigmentation.

The Science and Theory behind Facial Aging

“…However, in addition, the skin also goes through intrinsic changes over time on account of external and internal factors. 43,44 Some suggest that repetitive dynamic muscle contractions result in the appearance of superficial and deep rhytids over areas of habitual muscle contractions such as the orbicularis oculi and oris, risorius, frontalis, and corrugators on account of fascial partitioning and connections of the dermis and periosteum between the different facial muscle groups. Smoking and photodamage result in increased production of intracellular reactive oxidative intermediates and species and cause a multitude of facial skin changes resulting in epidermal thinning, solar elastosis, and dermal collagen disorganization, leading to characteristics consistent with aging skin (Fig.…”

“…Interestingly, other major components of extracellular matrix, glycoproteins and GAGs, tend to diminish with age, but they are increased in photoaged skin. 44–59 However, the increased GAGs are not found in the papillary dermis as usual; instead they are deposited in the reticular dermis within the elastotic material and are not able to regulate dermal hydration, leading to dry and leathery-appearing skin.…”

New Uses of AbobotulinumtoxinA in Aesthetics

“…32-38 This type of full face treatment also results in very high (>90%) patient satisfaction scores. 36,38 …”

“…These regimens frequently contain a retinoid and/or HA. Used daily, topical retinoids reverse photoaging by preventing destruction of the dermal matrix and promoting collagen formation, 38 while creams, serums, and gels containing HA can improve skin hydration and elasticity. 47 Other components of skincare regimens used in combination with BoNT-A include hydroquinone for skin lightening, and adenosine, which has been proposed to act by a number of mechanisms to reduce wrinkles and improve skin tone and texture.…”

Retinoids for the Cosmetic Patient

“…Retinoids have been combined with a variety of other products and procedures to enhance patient outcomes. The use of tretinoin .05 % cream with 4 % hydroquinone in patients undergoing injections of type A botulinum toxin to the upper face yielded signifi cantly greater improvements in the fi ne lines as well as the pigment of treated subjects (Schlessinger et al 2011 ).…”