A single session of treatment with a fractional carbon dioxide laser followed by botulinum toxin type A was associated with significant reduction of facial pores in a pilot study presented at the American Society for Laser Medicine and Surgery (ASLMS) 43^rd Annual Conference on Energy-based Medicine and Science in Baltimore.

Enlarged facial pores are a common aesthetic concern, and fractional carbon dioxide (FxCO2) has shown success in minimizing pore size, but its use in combination with intradermal botulinum toxin type A (BTX-A) has not been examined, wrote Nattaporn Sampattavanich, MD, of Phramongkutklao Hospital, Bangkok, Thailand, and colleagues in an abstract presented at the annual conference of the American Society for Laser Medicine and Surgery.

The researchers conducted a split-face pilot study of 15 adults with large facial pores. All participants underwent an initial session of FxCO2 applied to both cheeks, followed immediately by an injection of 16 units of BTX-A in one cheek and control saline in the other cheek. The participants ranged in age from 23-43 years and included 2 males and 13 females.

Pore size in both the combination treatment on control groups was significantly reduced at the initial 2-week follow-up compared to baseline (11.6% and 11.5%, respectively). The maximum average reduction in pore size was seen at 3 months after treatment, and was significant compared to baseline in both groups, although slightly greater in the combination group (25.1% vs. 19.8%). However, pore volume showed a significant decrease at 3 months and 6 months from baseline on the combination side only (49.7% and 36.9%). No significant reductions in sebum production compared to baseline were noted in either group.

"A singular FxCO2 treatment demonstrated a substantial reduction in enlarged facial pores lasting up to 3 months," the researchers said. "However, additional studies are warranted to investigate the potential synergistic effects arising from the combination of FxCO2 with topical BTX-A, aiming to achieve enhanced and prolonged treatment outcomes."

The findings were limited by the small sample size, but the results warrant additional studies to explore the potential synergistic effects of the FxCO2 topical BTX-A combination and optimize patient outcomes, the researchers wrote.

Sampattavanich N et al., A PROSPECTIVE, SPLIT-FACE, RANDOMIZED STUDY COMPARING FRACTIONAL CARBON DIOXIDE LASER WITH AND WITHOUT APPLICATION OF BOTULINUM TOXIN TYPE A IN THE TREATMENT OF ENLARGED PORES.Presented at: American Society for Laser Medicine and Surgery 43^rd Annual Conference on Energy-based Medicine and Science. April 11-14, 2024; Baltimore.