Objective To compare the efficacy and safety of different concentrations of type A botulinum toxin combined with skin booster injection in the treatment of facial photoaging. Methods A total of 120 patients with facial photoaging who were treated in the Dermatology Outpatient Department of Gaoming District People's Hospital of Foshan City from June 2023 to June 2024 were selected, and they were divided into group A, group B, group C and group D by the random number table method, with 30 patients in each group. Group A was given low-concentration type A botulinum toxin combined with skin booster injection, group B was given medium-concentration type A botulinum toxin combined with skin booster injection, group C was given high-concentration type A botulinum toxin combined with skin booster injection, and group D was given skin booster injection alone. The treatment effect, adverse reaction rate and scores of skin elasticity and fine lines and wrinkles were compared among the four groups. Results The total effective rates of treatment in group B and group C were higher than those in group A and group D (P <0.05). There was no significant difference in the incidence of adverse reactions among the four groups (P >0.05). The scores of skin elasticity and fine lines and wrinkles in group B and group C at 6 months after treatment were better than those in group A and group D (P <0.05). Conclusion Different concentrations of type A botulinum toxin combined with skin booster injection can effectively improve facial photoaging. Among them, the medium and high concentrations of type A botulinum toxin combined with skin booster injection are more effective and safe.