Syringomas are benign adnexal neoplasms that develop from eccrine sweat ducts. They are mostly found in early adulthood, with a female gender predominance. They typically occur on the face, particularly the periorbital region, which has a high demand for cosmetic enhancement. Management of periorbital syringomas is challenging, with no consistently effective treatment available. Intradermal injection of botulinum toxin A (BTX-A) is a new treatment modality for periorbital syringoma. We present a 53-year-old female patient with periorbital syringoma who was successfully treated with intradermal BTX-A monotherapy as a painless, cost-effective treatment that produced better long-term results than carbon dioxide laser.

Keywords: Botulinum Toxins, Type A; Syringoma; Carbon Dioxide

BACKGROUND: Combination therapies targeting multiple pathways of skin aging and hyperpigmentation are increasingly explored. However, the combined efficacy of gamma-aminobutyric acid (GABA), dimethylaminoethanol (DMAE), cysteamine, and bakuchiol remains limited.
OBJECTIVES: To assess the efficacy of a double-layer serum and cream containing GABA 3%, DMAE 2%, cysteamine 2.5%, and bakuchiol 1% on skin brightness, pore count, and wrinkles.
METHODS: In this 8-week, double-blind, randomized, placebo-controlled trial, 50 participants were randomized, and 44 completed the study. Subjects received either the active formulation or a placebo. Outcomes included wrinkle scores, pore counts, skin brightness (L-value), and melanin index assessed at baseline and weeks 2, 4, 6, and 8. Data were analyzed using repeated-measures MANOVA.
RESULTS: A significant time-by-group interaction was observed for L-value (p < 0.001), with the treatment group showing a modest increase (+1.63) compared to minimal change in controls (-0.49). Wrinkle scores changed over time in both groups without clinically meaningful between-group differences. No significant treatment effects were observed for pore counts or melanin index.
CONCLUSION: The formulation improved measured skin brightness but did not demonstrate significant depigmenting or structural anti-aging effects over 8 weeks, suggesting primarily cosmetic benefits.

Keywords: GABA Agents; Cysteamine; Aging