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The Effect of Full-Face Broadband Light Treatments Alone and in Combination With Bilateral Crow's Feet Botulinum Toxin Type A Chemodenervation



BACKGROUND Broadband light (BBL; Intense Pulsed Light; Lumenis Ltd., Yokneam, Israel) is a powerful, nonablative, light-based technology that targets melanin and hemoglobin and stimulates the formation of collagen and elastin. Botulinum toxin type A (BTX-A; BOTOX; Allergan Inc., Irvine, CA) treatment of the lateral periocular region relaxes the vertical fibers of the orbicularis oculi and results in softening of the lateral orbital crow's feet rhytides and widening of the palpebral aperture.

OBJECTIVE To compare the effects of full-face BBL in combination with BTX-A and BBL alone in female subjects with Fitzpatrick I–III skin types, Glogau II–III rhytides, and significant associated facial lentigines and telangiectasia.

METHODS This was a prospective, randomized study of 30 women with moderate to severe crow's feet rhytides. Half of the subjects were treated with BTX-A and BBL and the other half with BBL alone. Their response was assessed clinically and photographically. Skin biopsies of the temporal skin were taken from two subjects in each group and were stained with Masson trichrome.

RESULTS Patients treated with a combination of BTX-A and BBL experienced a better response to treatment, both at rest and on maximum smile, as well as a slightly improved response in associated lentigines, telangiectasia, pore size, and facial skin texture compared with patients who received BBL treatment alone. Skin biopsies showed an increase in dermal collagen in each group.

CONCLUSIONS The patients in this study benefited from both treatments. Although BBL led to a remarkable improvement in full-face telangiectasias, lentigines, and skin texture, the improvement increased in all categories with combination therapy. In addition, an added improvement in the full-face aesthetic with both BTX-A and BBL therapy combined was obvious. These results suggest that both treatments—although evidently complementary—may also act synergistically to produce optimal clinical effects, revolutionizing the treatment of facial aging.

*Clinical Professor, Opthalmology, University of British Columbia, Canada

Clinical Professor, Dermatology, University of British Columbia, Canada

Address correspondence and reprint requests to: Jean Carruthers, MD, Suite 740, 943 West Broadway, Vancouver, BC, Canada V5Z 4E1, or e-mail:

© 2004 by the American Society for Dermatologic Surgery, Inc.
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