Use of intradermal botulinum toxin to reduce sebum production and facial pore size.(ORIGINAL ARTICLES)(Report)

ABSTRACT

Objective: Review the safety profile and subjective efficacy of intradermal botulinum toxin type A in facial pore size and sebum production.

Design: Retrospective analysis of 20 patients.

Results: Twenty consecutive patients with a single application of intradermal botulinum toxin type A were examined: Patients (17/20) noted an improvement in sebum production and a decrease in pores size at 1 month after injection. No complications were observed, and 17/20 patients were satisfied with the procedure.

Conclusion: Preliminary data suggests that intradermal botulinum toxin may play a role in decreasing sebum production. Further quantitive study may be necessary to determine effects of intradermal botulinum toxin on pore size.

INTRODUCTION

Facial pore size and excessive sebum production are notoriously difficult skin conditions to treat. Numerous techniques have been described with limited results or significant drawbacks. A variety of skin resurfacing modalities have been described, but results have been mixed and inconsistent. One potential reason for this limitation is that the location of the sebaceous gland is in the deeper portion of the dermis, a difficult area to reach by resurfacing modalities.

Deeper resurfacing techniques can lead to hyperpigmentation and hypopigmentation, especially in patients with Fitzpatrick skin type 4 and higher, long recovery periods, and permanent scarring. The mechanism of isotrentinoin (Accutane[R]), is currently unknown, but it theoretically decreases sebum production. (1) However, a main drawback of isotrentinoin therapy is serious systemic side effects, including liver dysfunction, mucosal bleeding, and cardiac disease. In addition, several studies have suggested a possible link between isotrentinoin and depression, suicide, anxiety, and aggressive behavior. (2-6)

The use of intradermal botulinum toxin type A (Botox[R]) remains a relatively new technique. At the time of publication, no reports were found in the literature that describe its effects on sebum production and pore size. The author first noticed the effects of botulinum toxin on the skin after an injection along the procerus to treat "bunny lines." Patients reported improvement in skin quality and less skin shininess. Further investigation lead to isolated reports from Southeast Asia of physicians using…