Introduction <p>Botulinum toxin injections, commonly used for wrinkle reduction, have been found to improve skin quality, including elasticity and texture, when used intradermally. Recent studies suggest that combining botulinum toxin with other treatments, like polydeoxyribonucleotide (PDRN), may enhance the effectiveness of scar treatments. This case study explores the efficacy of combining air-botulinum toxin injections with PDRN for treating acne scars.</p> Methods <p>A prospective, open-label, randomized study involved 17 participants with Grade 2-5 acne scars. They were divided into 3 groups: Group 1 received air-botulinum toxin, Group 2 received PDRN, and Group 3 received both. Injections were administered at baseline, Week 4, and Week 8, with follow-ups at Week 16. The primary outcome was measured using the Patient and Observer Scar Assessment Scale (POSAS), along with patient satisfaction surveys and safety checks.</p> Results <p>Group 3, which received the combination treatment, showed the greatest improvement, with a 12.0-point reduction in POSAS scores. Group 1 saw a 9.0-point reduction, and Group 2 had a 6.1-point reduction. Patient satisfaction was highest in Group 3. All treatments were well-tolerated, with minor side effects like mild swelling and redness.</p> Conclusion <p>Combining air-botulinum toxin with PDRN injections shows promise for acne scar management, offering greater efficacy than single treatments. Further research is needed to confirm these findings and optimize treatment protocols.</p> Level of Evidence V <p>This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors <a href="http://www.springer.com/00266">www.springer.com/00266</a>.</p>