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Effect of carbon dioxide laser with botulinum toxin compared with carbon dioxide alone in treatment of periorbital syringoma

Background Periorbital syringoma is a benign adnexal tumor of eccrine origin that mostly affects middle-aged women. It consists of bilateral, multiple, yellow to flesh colored to brown firm papules. Aim To assess the effect of fractional CO2 laser with topical botulinum toxin compared with fractional CO2 laser alone in the treatment of periorbital syringomas. Patients and methods This split-face prospective study was carried out on 30 patients presented with periorbital syringomas. All patients were subjected to history taking, clinical examination, examination for site, number of syringomas, and photographic documentation. The patients were treated by fractional CO2 laser and immediately followed by 0.1 cm of diluted Botox (by gentle hand massage) in the right eyelid, whereas the left eyelid was treated by fractional CO2 laser only. The patients were subjected to two sessions with 4–6-week interval. Results There was a statistically significant increase in the response to treatment by fractional CO2 laser followed by topical Botox (P=0.039). The percentage of improvement was 95.5%. Conclusion The use of fractional CO2 laser combined with topical botulinum toxin in treatment of periorbital syringomas has better results than the use of fractional CO2 laser only.