Optimized Patient Outcomes With the Novel Modality of Corrective Chemical Peel and Neurotoxin on Same-Day Treatment

January 2024 | Volume 23 | Issue 1 | 1349 | Copyright © January 2024


Published online December 13, 2023

doi:10.36849/JDD.7194R1

Wendy E. Roberts MD FAAD, Nancy Miller RN MBA

Private Practice, Generational & Cosmetic Dermatology, Rancho Mirage, CA

Abstract
Background: This study was conducted to improve standards of care in the cosmetic treatment of sun damage, fine lines, and wrinkles. Chemical Peels and Neurotoxins have been traditionally used cosmetically as monotherapies. This study aimed to confirm that the same-day combination created no additional side effects while also improving outcomes.
Methods: The multi-generational study enrolled 30 patients with Fitzpatrick I-VI representation. The Roberts Skin Type Classification System was used to establish baseline patient information. Patients were treated with a VI Peel®, followed by Botox®. Objectively, photographic matching, Wrinkle Severity Scale, Uniformity of Pigment Scale, and Skin Tone Scales were used to evaluate skin improvement. Patient questionnaires were issued to assess satisfaction.
Results: Safety of the same-day combination was established with no adverse events reported. Improvements on the Wrinkle Severity Scale showed an average rating dropping from 1.46 to 0.59 representing a 60% improvement. Improvements on the Uniformity of Pigment Scale showed an average rating dropping from 2.27 to 0.92 representing a 59% improvement. Improvements on the Skin Tone Scale showed an average rating dropping from 2.35 to 0.71 representing a 70% improvement. Questionnaires correlated with objective findings with high satisfaction. 
Conclusion: This study confirmed the safety of the same-day combination. The efficacy of VI Peel & Botox same-day treatment was clinically proven by the improvements to Wrinkle Severity, Uniformity of Pigment, and Skin Tone via photographic matching. While perception studies indicated strong patient satisfaction with the combination. 

J Drugs Dermatol. 2024;23(1):1349-1354.   doi:10.36849/JDD.7194R1

INTRODUCTION

The medical aesthetics industry is a high-growth industry slated to reach 18 billion by 2027. This growth is primarily driven by minimally invasive and non-invasive cosmetic procedures according to All the Research 2020 Report.1 

The top 5 most performed minimally invasive therapies reported by the American Society of Plastic Surgeons include Botulinum Toxin Type A, Soft Tissue Fillers, Chemical Peels, Laser Skin Resurfacing, and Intense Pulsed Light treatments comprising over 13 million patient visits in 2020.2 The diversity in the market continues to also evolve with not only a greater percentage of men receiving cosmetic treatments but also growth in familial aesthetics with grandparents, parents, and their adult children seeking both preventative and corrective care. As the aesthetic market continues to grow, advancements in optimal care have also evolved. 

This study was conducted to improve standards of care in the cosmetic treatment of sun damage, fine lines, and wrinkles. Chemical peels and neurotoxins have been used cosmetically to improve patient concerns as monotherapies. This study aimed to confirm that the same-day treatment combination creates no additional side effects and that patient results and satisfaction are heightened as a result.

Collagen degradation and wrinkling of the skin are caused by multiple intrinsic and extrinsic factors. Addressing wrinkling in the skin is often accomplished by reducing muscle contractions with the aid of neurotoxins as well as the use of chemical peels to improve skin elasticity, stimulate collagen regeneration, and textural refinements. 

Trials on chemical peels and botulinum toxin are vast, but research on the combination of the two therapies is minimal. One study published in 2006 by Marina Landau, MD, addressed the combination with the inclusion of both staggered and same day treatments.3 The findings indicated safety of same-day applications if only superficial and medium-depth chemical peels were used in treatment. 
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