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Background Hyaluronic acid (HA) is a key contributor to skin moisture (hydration), and MicroBotox demonstrates improvements for fine wrinkles of the face. Objectives The author sought to evaluate the safety and efficacy of intradermal injection of hydrotoxin (combined mixture of MicroHA and MicroBotox) for the treatment of skin roughness and dryness on facial dermis. Methods Fifty women who had thin, dry skin with fine wrinkles throughout the whole face, especially in the crow’s feet and forehead areas, were enrolled in the study. Two cc stabilized-HA filler and 1 cc (40 U) of botulinumtoxinA were mixed in the novel combined hydrotoxin mixture. Intended to hydrate the dermis and treat fine wrinkles of the face, the mixture was injected into the real dermal layer of the face. The volume of HA per site was 0.002 cc and toxin was 0.04 U. Skin roughness and stratum corneum hydration were measured at 1, 2, 3, and 6 months. Results One month post-treatment, skin roughness was reduced to 50.19% in topographic computer analysis utilizing 10× dermascope photos. Stratum corneum hydration on crow’s feet improved to 81.34% at 1 month and 56.12% at 2 months from pre-treatment baseline (P &amp;lt; 0.0001). Global Aesthetic improvement scale of Skin hydration and fine wrinkle improved. Conclusions The combination injection method of MicroHA and MicroBotox is not associated with side effects and showed significant synergic effect in improvement of skin roughness and moisturizing. Neuramix-hydrotoxin injection method is an easy and reproducible procedure to make constant injection depth and amount. Level of Evidence: 4

Fine Wrinkle Treatment and Hydration on the Facial Dermis Using HydroToxin Mixture of MicroBotox and MicroHyaluronic Acid