I have used Botox for the treatment of acne on a selective group of patients with their understanding that this is a mode of treatment that is not currently FDA approved. The results with my patients have been successful and without complication; however, the procedure carries risk. If the injection is not in the correct location this may lead to adverse consequences such as altering patients facial expressions. I also agree that the mode of treatment should be reserved to those patients over the age of 21 who have progressed and experienced permanent horomonal changes.
The findings should be verified with randomized controlled trials in as far as Botox inhibiting comedognesis is speculative, possibly through interrupting colonergic transmission or by unknown secretory, trophic or anti-inflammatory effects. Further study may help determine the effectiveness of intradermal botulism toxin and degree of improvement with this therapy; however, botulism toxin injections appear to be a promising and novel treatment for acne.