Facial Acne Management and Sebum Reduction via Botulinum Toxin Type A Treatment: A Review

Context: Acne is a common skin condition characterized by chronic inflammation of the pilosebaceous unit. Increased sebum production is a key component of acne pathogenesis. Various therapies are available for acne, including topical, systemic, and physical treatments. Botulinum toxin is increasingly used in facial cosmetic procedures. Observations suggest that botulinum toxin type A (BoNT-A) may reduce sebum levels in the face. This finding could potentially lead to the development of a new treatment for oily skin and acne. Evidence Acquisition: A retrospective literature review was conducted by searching the PubMed, Web of Science, EMBASE, and SCOPUS databases using keywords such as "acne," "acne treatment," "oily skin," and "botulinum toxin type A." The review focused on studies that assessed the impact of BoNT-A on patients with acne vulgaris and oily skin, as well as studies that measured skin sebum levels and pore size following BoNT-A application. Results: Nine studies were reviewed. Of these, two evaluated the effects of BoNT-A on 30 and 35 patients with acne vulgaris. Four studies assessed sebum reduction in 20, 50, 42, and 20 patients. Three studies evaluated both sebum reduction and pore size tightening in 10, 25, and 20 patients. Eight studies demonstrated that the application of BoNT-A has a positive effect on patients with acne and reduces sebum production in facial skin. Only one study, which evaluated both sebum reduction and pore size tightening, found no significant effect. Overall, the studies indicate that BoNT-A application can positively impact acne and reduce facial sebum production. Specifically, intradermal application of BoNT-A at low dosages can help reduce acne, sebum production, and tighten pores. Conclusions: BoNT-A shows promise as a treatment for acne and oily skin. While cost-effectiveness may be a challenge for some patients, the benefits of BoNT-A make it a treatment option worth considering. With further studies to optimize dosages and determine the longest duration of efficacy, BoNT-A has the potential to revolutionize the treatment of acne and oily skin.