Role of Botulinum Toxin in Sebum Regulation and Acne Vulgaris: A Mini Review

Abstract

Background: Botulinum toxin is a potent neurotoxin produced by Clostridium botulinum and has been used clinically since the late 1970s. Among its different serotypes, botulinum toxin type A is the most widely used in medical and aesthetic practice because of its ability to inhibit acetylcholine release at neuromuscular junctions and autonomic nerve terminals. In dermatology, botulinum toxin has established and emerging roles in both cosmetic and non-cosmetic indications, including hyperhidrosis, facial wrinkles, facial contouring, rosacea, wound healing, scar prevention, keloids, hypertrophic scars, and several inflammatory skin disorders. Recently, intradermal botulinum toxin A has gained attention as a potential treatment for oily skin, enlarged pores, seborrhea, and acne vulgaris. Its proposed therapeutic effect in acne is mainly related to reduction of sebum secretion through inhibition of cholinergic stimulation of sebaceous glands and paralysis of arrector pili muscles, thereby decreasing sebum output on the skin surface. Although current evidence suggests promising benefits, further well-designed studies are still required to standardize dosing, injection techniques, efficacy, and safety in dermatological practice.