Carbon dioxide laser combined with botulinum toxin A for patients with periorbital syringomas

Background: Although various destructive methods have been described for treating syringomas, they are often associated with significant scarring and recurrence. In 2007, multiple-drilling method using carbon dioxide (CO₂) laser was introduced as an alternative modality to gain good cosmetic results. Objective: To retrospectively evaluate the effectiveness of CO₂ laser combined with botulinum toxin A (BTXA) as treatment for syringomas. Material and methods: Forty-eight patients with periorbital syringomas were treated with topical application of BTXA immediately after CO₂ laser treatment. Forty-four patients were treated with CO₂ laser only. Results: Patients who were treated with CO₂ laser combined with BTXA required significantly (p = 0.038) fewer treatment sessions compared with those treated with CO₂ laser only. When the clinical improvements of the two treatment sessions were compared, the combined therapy (CO₂ laser and BTXA) had significantly (p = 0.044) higher rate of results showing good (disappearance of 60–80% of lesion) or excellent (80–100%) than the CO₂ laser only therapy (87.5% vs. 70.5%). Conclusions: CO₂ laser combined with BTXA showed better effect than CO₂ laser only.