title: Further enhancement of facial appearance with a hydroquinone skin care system plus tretinoin in patients previously treated with botulinum toxin Type A.
abstract: BACKGROUND
  A hydroquinone (HQ) skin care system has been designed for use in conjunction with nonsurgical procedures.
  
  
  OBJECTIVE
  The authors evaluate the efficacy of this system plus tretinoin for improving facial appearance in comparison to a standard skin care regimen in users of botulinum toxin Type A (BoNT-A).
  
  
  METHODS
  In this multicenter, randomized, investigator-masked, parallel-group study, 61 patients who received upper facial treatment with BoNT-A at a plastic surgery or dermatology clinic were randomly assigned to apply either the HQ system (cleanser, toner, proprietary 4% hydroquinone, exfoliant, and sunscreen) plus 0.05% tretinoin cream or a standard skin care regimen (cleanser, moisturizer, and sunscreen) for 120 days. Outcomes were assessed by the investigators and through a patient questionnaire.
  
  
  RESULTS
  Compared with standard skin care, the HQ system plus tretinoin resulted in significantly milder fine lines/wrinkles and hyperpigmentation at Days 30, 90, and 120 (p ≤ .05) and significantly superior overall ratings for each of nine patient assessments at Days 90 and 120 (p ≤ .05). A relatively greater proportion of patients using the HQ system plus tretinoin believed that their study treatment had further enhanced the improvements attained with BoNT-A (86% vs 8%). Both regimens were generally well tolerated.
  
  
  CONCLUSIONS
  Adjunctive use of the HQ system plus tretinoin can further enhance the improvements in facial appearance attained with BoNT-A. Applying the HQ system plus tretinoin offers multiple clinical benefits over standard skin care, including significantly greater improvements in fine lines/wrinkles and hyperpigmentation.
authors: Department of Plastic Surgery, University of Texas Southwestern, Dallas, TX, USA.
authors: Joel
authors: J
authors: Schlessinger
authors: Jeffrey
authors: J
authors: Kenkel
authors: Philip
authors: P
authors: Werschler
mesh_terms: D000279:Administration, Cutaneous; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage; D005145:Face; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006873:Hydroquinones / Q000008:administration & dosage* / Q000009:adverse effects; D017495:Hyperpigmentation / Q000188:drug therapy; D007641:Keratolytic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D012060:Rejuvenation; D015595:Skin Aging / Q000187:drug effects*; D017592:Skin Care / Q000379:methods; D011795:Surveys and Questionnaires; D013997:Time Factors; D014212:Tretinoin / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D006873:Hydroquinones; D007641:Keratolytic Agents; D014212:Tretinoin; D019274:Botulinum Toxins, Type A; C031927:hydroquinone