INTRODUCTION
Botulinum toxin (BTX) has been widely applied for various cosmetic indications, such as glabellar rhytides, crow’s feet, eyelid wrinkles, perioral wrinkles, chin rhytides, masseter hypertrophy, and platysmal bands, since its first aesthetic approval by the US FDA in 2002 for the treatment of glabella lines.1-5 Currently, BTX is one of the most popular minimally invasive cosmetic procedures performed.6
The primary mechanism of BTX is muscle paralysis via inhibiting the exocytosis of presynaptic acetylcholine,7 and wrinkles related to muscular contraction can be improved by intramuscular injection of BTX.5 More recently, intradermal injection of BTX has been used off-label for various aesthetic conditions, including facial skin laxity, excess sebum production, and enlarged facial pores.8-13 These effects could be attributed to the paralysis of arrector pili muscles or decreased sebum production via acetylcholine inhibition.10,13,14 However, previous studies relied on subjective evaluation and lacked long-term clinical data. Regarding sebum production or facial pore reduction, some studies showed conflicting results.10,15 Additionally, previous studies applied intradermal injections of Abobotulinumtoxin-A (ABO) or Onaboulinumtoxin-A (ONA), but no currently published study used Incobotulinumtoxin-A (INCO) for these indications.
INCO is a highly purified and precisely manufactured BTX type A preparation, which contains the pure 150 kDa active neurotoxin without complexing proteins.16 Without complexing proteins, INCO is known to have a low antigenicity compared to that of other products of BTX type A.1,17,18 INCO is also free of other impurities/adjuvants, such as inactive neurotoxin, flagellin, and clostridial DNA contaminants.17 Here, we retrospectively reviewed patients who received facial treatments with intradermal INCO and evaluated the changes in sebum production, face lifting, and facial pore improvement for up to 12 weeks after a single treatment session.
The primary mechanism of BTX is muscle paralysis via inhibiting the exocytosis of presynaptic acetylcholine,7 and wrinkles related to muscular contraction can be improved by intramuscular injection of BTX.5 More recently, intradermal injection of BTX has been used off-label for various aesthetic conditions, including facial skin laxity, excess sebum production, and enlarged facial pores.8-13 These effects could be attributed to the paralysis of arrector pili muscles or decreased sebum production via acetylcholine inhibition.10,13,14 However, previous studies relied on subjective evaluation and lacked long-term clinical data. Regarding sebum production or facial pore reduction, some studies showed conflicting results.10,15 Additionally, previous studies applied intradermal injections of Abobotulinumtoxin-A (ABO) or Onaboulinumtoxin-A (ONA), but no currently published study used Incobotulinumtoxin-A (INCO) for these indications.
INCO is a highly purified and precisely manufactured BTX type A preparation, which contains the pure 150 kDa active neurotoxin without complexing proteins.16 Without complexing proteins, INCO is known to have a low antigenicity compared to that of other products of BTX type A.1,17,18 INCO is also free of other impurities/adjuvants, such as inactive neurotoxin, flagellin, and clostridial DNA contaminants.17 Here, we retrospectively reviewed patients who received facial treatments with intradermal INCO and evaluated the changes in sebum production, face lifting, and facial pore improvement for up to 12 weeks after a single treatment session.
METHODS
Study Design and Patients
This study was a single-center, retrospective clinical study. The
This study was a single-center, retrospective clinical study. The