Botox Cosmetic has been approved for cosmetic purposes since 2002, and we’re all familiar with its safety and effectiveness in reducing facial lines and wrinkles. Since then, the use of Botox has expanded to include the treatment of such conditions as excessive sweating and even migraine headaches. Now, the newest and most promising area for the use of Botox Cosmetic is for the treatment of acne and for the reduction of pore size.

Acne is one of the most commonly occurring skin conditions.  The American Academy of Dermatology estimates that nearly 100% of teenagers have at least an occasional acne breakout.  More concerning is the estimated 40% of teenagers that seek the attention of a physician for acne treatment. In its most severe form, cystic acne, the scars that it leaves on the face can affect an individual for a lifetime. The exact cause of acne is not known, but it is thought to result from a combination of factors including excess oil or sebum production and ineffective exfoliation resulting in pore clogging, bacterial overgrowth and inflammation.

Now here’s where Botox comes into the picture. Dating back to 2008, physicians who inject Botox noticed that some of their patients were reporting a decrease in acne breakouts. In an article in the Journal of Drugs in Dermatology in September of 2008, Chicago plastic surgeon Anil Shah MD published the results of a small uncontrolled study he performed with 20 patients using Botox injected into the facial skin to control acne and reduce pore size.

In that study, Dr. Shah injected Botox very superficially into the dermis of the study participants. One month after a single injection session, 17 out of the 20 patients reported a decrease in oil production and a decrease in the size of their facial pores in the area of the injections. No complications were reported.

Dr. Shah postulated that the Botox works to block acetylcholine release at the nerve receptors in the sebaceous glands of the dermis, thereby reducing their production of oil and sebum. In addition to that, Dr. Shah postulated that the superficial dermal location of the Botox injections also paralyzed the tiny “erector pili” muscles, which are the little muscle that surround the skin’s pores and cause them to expand.

Of course, the results of this trial need to be taken with some caution. Larger, placebo-controlled trials need to be done to confirm the safety and efficacy of Botox for an acne and pore size indication.  It’s also important to keep in mind that the technical expertise of the Botox injector can’t be underestimated in this situation, as Botox injections done at the improper depth or location can result in facial muscle paralysis and unwanted cosmetic side effects.  Lastly, there already exist many treatments for acne that are much less expensive and already proven to be safe and effective.

For now, the use of Botox for acne and pore size warrants further study and caution, but it is an exciting area of promise for the wrinkle treatment we all know and love.