SYNERGISTIC EFFECTS OF COMBINATORIAL THERAPY WITH BOTULINUM TOXIN AND POLYNUCLEOTIDES ON DYNAMIC AND STATIC FROWN WRINKLES

Abstract

Background Frown wrinkles, both dynamic and static, are among the most common cosmetic concerns in aesthetic practice. Botulinum toxin type A has long been the standard treatment for dynamic wrinkles, but its effect on static lines is limited. Polynucleotides have recently been introduced as bio-revitalizing agents, and their combination with botulinum toxin may offer synergistic benefits Aim The study aimed to evaluate the synergistic effects of botulinum toxin type A and polynucleotides compared to botulinum toxin alone on the improvement of dynamic and static frown wrinkles. Methods A prospective interventional trial was conducted at Dr. Gul Aesthetic Academy between August 2024 and July 2025. Sixty patients aged 30–60 years with moderate to severe frown wrinkles were randomly assigned to two groups: Group A received botulinum toxin type A alone, and Group B received botulinum toxin type A followed by intradermal polynucleotide injections two weeks later. Outcomes were assessed using the Wrinkle Severity Rating Scale (WSRS), Global Aesthetic Improvement Scale (GAIS), patient satisfaction scores, and adverse event monitoring. Statistical analysis was performed using SPSS version 26.0 with t-tests and chi-square tests. Results Group B demonstrated significantly greater improvement in WSRS and GAIS scores at 2 weeks, 3 months, and 6 months compared to Group A (p < 0.001). Patient satisfaction was higher in Group B (60% very satisfied) compared to Group A (30% very satisfied). Both groups reported only mild and transient adverse events without serious complications. Conclusion Combination therapy with botulinum toxin and polynucleotides provided superior and longer-lasting wrinkle reduction with higher patient satisfaction compared to botulinum toxin alone, with an acceptable safety profile.