CLINICAL TRIAL article
Front. Med.
Sec. Dermatology
Efficacy and Safety of Intradermal Botulinum Toxin A for Post-Acne Erythema: A Split-Face Randomized Controlled Trial
Provisionally accepted
- Henan Provincial People's Hospital, Zhengzhou, Henan Province, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
ABSTRACT Introduction: Post-acne erythema (PAE) is a common aesthetic sequela in patients with acne. Although numerous treatments for PAE have been investigated, the efficacy of intradermal botulinum toxin A (BTX-A) remains controversial. This study aimed to evaluate and compare the efficacy and safety of intradermal BTX-A versus broadband light (BBL) for treating PAE. Materials and methods: This study included 30 patients diagnosed with PAE at the Dermatology Outpatient Department of Henan Provincial People's Hospital in China between January 2023 and July 2023. In a split-face design, one cheek of each patient was randomly assigned to receive a single intradermal injection of BTX-A (experimental group), while the other cheek received three BBL treatments at one-month intervals (control group). The Clinician Erythema Assessment (CEA) score, VISIA results, L*a*b* values, skin physiological parameters, and adverse events were compared between the two groups. Results: The two groups showed no significant differences in baseline characteristics. At the one-month follow-up, the experimental group demonstrated significantly greater reduction in CEA, erythema index (EI), a* value, and sebum secretion compared to the control group (P < 0.05). The reduction in sebum secretion remained significantly greater in the experimental group at both the two-and three-month follow-ups (P < 0.05). Additionally, the experimental group showed a significantly greater reduction in the CEA score at two months and in the a* value at three months (P < 0.05). Compared to baseline, both groups exhibited a declining trend in EI, transepidermal water loss (TEWL), CEA score, sebum secretion, and a* value, along with an increase in skin hydration. Pain or discomfort, assessed by the Visual Analog Scale, was significantly higher in the experimental group (P < 0.001); however, there was no significant difference in satisfaction scores between the groups. Conclusion: In this split-face study, a single session of intradermal BTX-A was superior to a multi-session BBL regimen in reducing PAE over three months, with a comparable safety profile. These findings suggest that intradermal BTX-A is a promising and viable therapeutic option for PAE, warranting further investigation in larger, long-term studies.
Keywords: Post-acne erythema, Botulinum toxin type A, Intradermal injection, randomized controlled trial, Clinician Erythema Assessment
Received: 11 Apr 2025; Accepted: 03 Nov 2025.
Copyright: © 2025 Yang, Gao, Wu, Li, Li and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Xueli Li, 15515912211@163.com
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.