T ON:
BOTOX FOR ACNE

Thanks to its myriad applications – wrinkle, perspiration, and migraine prevention, for starters – Botox is beginning to seem like a more comprehensive cure-all than the Windex of My Big Fat Greek Wedding. Now many veteran injectors have added oil controller –and potential acne fighter- to the list, based on clinical and anecdotal observations of the drug’s effect on sebum flow. Skin is noticeably clearer in Botox-treated areas, says Mount Kisco, New York, dermatologist David E. Bank, MD, whose wife requests her touch-ups not as lines reappear but when her T-zone starts to look too shiny.

Although there aren’t yet any published studies proving these claims, experts believe that this fortunate side effect is due to the toxin’s muscle-paralyzing powers. A relaxed duct doesn’t continually pump out sebum, so glands aren’t stimulated to refill, says Anna D. Guanche, MD, a clinical instructor of dermatology at the David Geffen School of Medicine at the University of California, Los Angeles. Facial surgeon Anil Shah, MD, one of the first doctors in New York City to use Botox to stall sebum, hypothesizes that the toxin slackens the microscopic muscles surrounding each piece by blocking nerve transmission acetylcholine, a chemical that influences oil manufacture.

To treat wrinkles, Botox is shot deep inside muscles, but for sebum minimization doctors inject a saline-diluted superficially into skin’s top layers. I focus on areas where pores the most prevalent, usually the nose, cheeks, and forehead, Shah says, adding that, depending on the patient, results can be seen in as little as 24 hours and last for approximately four months (the same amount of time Botox would typically hold up anywhere else).
The drug’s ability to reduce oil means it could control acne as well. With less sebum, bacteria can’t  thrive within the pore and cause inflammation, Shah says. Ann Tilton, MD, a professor of neurology and pediatrics at the Louisiana State University Health Sciences Center in New Orleans, treated 15 severe-acne sufferers with diluted Botox and found a dramatic reduction in breakouts 12 weeks posttreatment. Outright pore blockage doesn’t seem to be a problem, since oil still flows to the skin surface – just at a much slower rate.
Still, some Botox experts are wary of administering the toxin across large areas of the face (versus the pointed-muscle-approach). While admitting that possibility is very rare, Miami dermatologist Fredric Brandt, MD, says, I’m still concerned that the toxin could penetrate deeper and trigger overall facial weakening. But for those on a quest for a shine- free complexion, salvation may be worth a shot.

NICOLE CATANESE.