Combined Use of Botulinum Toxin A and Profhilo for Upper Face Rejuvenation: A Randomized Clinical Trial

ABSTRACT Background Hyaluronic acid (HA) and Botulinum toxin A (BTX‐A) treatments are highly regarded for their effectiveness in facial rejuvenation. Aim To investigate whether adding Profhilo enhances the effects of BTX‐A for frontal skin rejuvenation. Method In a prospective clinical trial, 10 subjects were treated by upper face Profhilo plus Botulinum toxin A injection, and 10 age‐ and sex‐matched controls received only Botulinum toxin A injection. Clinical and sonographic improvement were compared 3 months after the last treatment session. Results A total of 20 participants (10 patients in each group), including 8 males (80%) and 2 females (20%) in the case group and 7 males (70%) and 3 females (30%) in the control group, were enrolled in the study. According to Merz scores before and 3 months after treatment, the wrinkles were dramatically reduced in both groups ( p value: < 0.001 for each group), with treatment results not significantly different between two groups ( p value: 0.633). None of the sonographic variables, including dermis and hypodermis thickness and elasticity, significantly changed after treatment with BTX‐A alone ( p values: 0.910 and 0.770, respectively) or with Profhilo injection ( p values: 0.261 and 0.670, respectively). Conclusion We have shown that adding Profhilo to BTX‐A injection does not have any short‐term clinical or sonographic advantage in frontal area wrinkle reduction. Further prospective studies with a longer follow‐up period are warranted to evaluate any potential long‐term effects.