title: Does laser inactivate botulinum toxin?
abstract: BACKGROUND
  Botulinum toxin is a popular and effective treatment for dynamic rhytids. It is a neurotoxic protein complex that exerts its effect by inhibiting acetylcholine release at the presynaptic neuromuscular junction. Nonablative resurfacing treatments have also become well liked by patients and physicians owing to the minimal downtime associated with treatment. Currently, same-day nonablative laser treatments are performed prior to botulinum toxin injection owing to the concern that the laser may inactivate it. On occasion, it may be desirable to perform nonablative laser after the botulinum toxin has been injected (ie, patient afterthought, scheduling concern).
  
  
  OBJECTIVE
  To determine whether the use of nonablative rejuvenation laser or intense pulsed light (IPL) immediately following botulinum toxin injections has any effect on the efficacy of the botulinum toxin treatment.
  
  
  METHODS
  Nineteen subjects received botulinum toxin injections to either the glabellar or crow's-feet areas. One side of the treated glabellar or periorbital area was treated with either VBeam laser (Candela, Wayland, MA, USA), SmoothBeam laser (Candela), CoolGlide laser (Cutera, Brisbane, CA, USA), or an IPL or radiofrequency (RF) device within 10 minutes of botulinum toxin injection. Pretreatment and 2-week post-treatment photographs were compared.
  
  
  RESULTS
  No decrease in the efficacy of botulinum toxin denervation was observed when glabellar or perioral areas were treated with VBeam laser, SmoothBeam laser, CoolGlide laser, or an IPL or RF device within 10 minutes of botulinum toxin injection.
  
  
  CONCLUSIONS
  Patients may be treated with several nonablative lasers and IPL or RF devices immediately after botulinum toxin injection without loss of efficacy or other apparent untoward effect.
authors.affiliation: Laser and Skin Surgery Center of Northern California, Sacramento, California, USA. nsemchyshyn@skinlasers.com
authors.forename: Natalie L
authors.initials: NL
authors.lastname: Semchyshyn
authors.forename: Suzanne L
authors.initials: SL
authors.lastname: Kilmer
mesh_terms: D000328:Adult; D000368:Aged; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D053685:Laser Therapy; D008875:Middle Aged; D009465:Neuromuscular Agents / Q000627:therapeutic use*; D015361:Rhytidoplasty; D015595:Skin Aging / Q000187:drug effects*
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A