Beyond Muscle: A Narrative Review of Onabotulinum Toxin A for Skin Quality.

BACKGROUND Onabotulinum toxin A’s (BoNTA’s) popularity is centered on its quick, predictable, and safe ability to improve clinically apparent rhytides. While this remains the only FDA indication for BoNTA, recent research suggests that BoNTA may have a much wider use for the improvement of overall skin quality. OBJECTIVE This review will focus on the various evidence and uses of BoNTA for improvement of skin quality. MATERIALS AND METHODS This review considered published journal articles (clinical trials, case studies, scientific reviews). Studies were identified by searching the PubMed database and reference lists of respective articles. Only articles available in English were considered for this review. RESULTS Intramuscular and intradermal injections of BoNTA decrease sebum production, pore size, facial erythema and flushing, and resting lines. BoNTA induces neocollagenesis and restores the extracellular matrix. CONCLUSION The literature provides both in vivo and in vitro evidence that BoNTA enhances skin quality beyond its well-studied neuromuscular effect. J Drugs Dermatol. 2021;20(9):958-962. doi:10.36849/JDD.6038.