Journal Digest: August 26, 2026

Clinical, Cosmetic, and Investigational Dermatology | Exploring the Therapeutic Potential of Botulinum Toxin in Treating Post-Acne Sequelae: A Critical Review

A critical review examined the potential role of intradermal microdroplet botulinum toxin for post-acne erythema, atrophic scars, and enlarged pores. The therapy may have anti-inflammatory, vascular, sebaceous, and fibroblast-modulating effects, providing a rationale for its use beyond traditional muscle paralysis. However, clinical evidence remains limited. Atrophic acne scars have the strongest support, with low-to-moderate evidence suggesting botulinum toxin may provide an early additive benefit when combined with microneedling, lasers, or radiofrequency, although its independent contribution remains unclear. Evidence for post-acne erythema is also low to moderate and is based on only a small randomized trial and an uncontrolled study. Data for enlarged pores are particularly weak, relying largely on retrospective and before-and-after studies. The review also highlights a lack of standardized dosing, dermal penetration data, and long-term safety or immunogenicity monitoring. Overall, botulinum toxin should be considered investigational or adjunctive rather than a first-line treatment.¹

Journal of Cosmetic Dermatology | Cosmetic Outcomes and Safety of Hair Transplantation and Topical Minoxidil for Temporal Triangular Alopecia: A Systematic Review

Another systematic review evaluated topical minoxidil and hair transplantation for temporal triangular alopecia (TTA), a rare, non-scarring alopecia often diagnosed in childhood. Nine studies involving 23 patients were identified, all case reports or case series. All 3 patients treated with topical minoxidil experienced cosmetic improvement, with visible regrowth reported as early as 4 weeks; relapse after discontinuation occurred in 1 case. Among 20 patients undergoing FUT or FUE, all demonstrated cosmetic improvement, with coverage of 75% to 100% and results maintained for up to 6 years in one case. Both approaches had favorable safety profiles, with only minor local adverse events and no serious events reported. The authors suggest topical minoxidil may be considered for pediatric patients or those seeking non-surgical treatment, while transplantation may offer durable correction for adults. However, the evidence is Level IV and limited by small samples, subjective outcomes, and lack of comparative trials.²

Pediatric Dermatology | Growth Assessment in Children Under 12 Years With Moderate-to-Severe Atopic Dermatitis Included in the PEDISTAD Observational Registry

A cross-sectional analysis of 1,329 children younger than 12 years with moderate-to-severe atopic dermatitis (AD) in the PEDISTAD registry found differences in growth compared with US CDC reference percentiles. Among children aged 5 to <12 years, 72% of boys and 53% of girls were below the 50th percentile for height, while 56% of boys and 52% of girls were above the 50th percentile for weight. Consequently, 70% of boys and 71% of girls had BMI above the 50th percentile. Height differences were less pronounced among children younger than 5 years. Although children experienced substantial itch, sleep disturbance, and disease burden, exploratory analyses did not identify direct associations between growth measures and disease severity, sleep, itch, corticosteroid use, or atopic comorbidities. The findings suggest moderate to severe AD may be associated with reduced linear growth and higher BMI, particularly among boys aged 5 to <12 years. Longitudinal research is needed to determine whether effective disease control can normalize growth.³

Dermatologic Therapy | Multimodal Ultrasound and Multispectral Imaging Combined With Investigator Global Assessment for Quantitative Evaluation of Rosacea: A Feasibility Study

A feasibility study explored whether multimodal imaging could provide more objective measures of rosacea than visual assessment alone. Researchers evaluated 20 patients with rosacea and 20 age- and sex-matched healthy controls using grayscale ultrasound, shear wave elastography, ultramicro angiography (UMA), multispectral imaging (MSI), and Investigator Global Assessment (IGA). Compared with controls, patients with rosacea had reduced epidermal and dermal thickness, increased dermal microvascular perfusion, greater skin stiffness, and higher erythema measures. UMA-derived color pixel percentage (CPP) demonstrated the strongest ability to distinguish rosacea from healthy skin (AUC, 0.932). After 4 weeks of barrier-repair therapy, epidermal and dermal thickness increased, while CPP, erythema area ratio, and IGA scores decreased; elasticity measures did not significantly change. The findings suggest multimodal imaging may complement clinical assessment by objectively capturing structural, vascular, and erythema-related changes. However, the small, single-center study and lack of an untreated control group limit conclusions, and the technology remains investigational.⁴

Journal of Cosmetic Dermatology | Skin Barrier and Dermal Edema Recovery Using Ideal-Sized Chitosan After Microneedle Radiofrequency: A Split-Face Case Report

In this letter to the editor, authors detailed a split-face case report evaluating whether ideal-sized chitosan (ISC) could support recovery following microneedling fractional radiofrequency (MNRF), which can temporarily disrupt the epidermal barrier and cause inflammation and dermal edema. A 32-year-old man received MNRF, with ISC applied immediately to the left side of the face and the untreated right side serving as a control. Investigators measured stratum corneum hydration, transepidermal water loss (TEWL), erythema, and dermal ultrasound findings over 72 hours. Following treatment, the ISC-treated side demonstrated faster reductions in TEWL, erythema, and low-echogenic pixels associated with dermal edema. At 24 hours, TEWL was 15.8 g/m²/h on the ISC-treated side versus 20.6 g/m²/h on the control side, while hydration increased substantially. Delayed ISC application at 48 hours was also followed by accelerated recovery. However, the single-patient design, short follow-up, and potential occlusive effects limit conclusions. Larger controlled studies are needed to validate ISC after MNR.⁵

References

1. Liao X, Wu J, Cheng H, Zheng H, Peng Y. Exploring the Therapeutic Potential of Botulinum Toxin in Treating Post-Acne Sequelae: A Critical Review. Clinical, Cosmetic and Investigational Dermatology, 19, 2026. doi:10.2147/CCID.S628704

2. AlRoujayee A. Cosmetic Outcomes and Safety of Hair Transplantation and Topical Minoxidil for Temporal Triangular Alopecia: A Systematic Review. J Cosmet Dermatol. 25, no. 8 (2026): e71140, doi:10.1111/jocd.71140

3. Paller AS, Irvine AD, Baselga E, et al. Growth Assessment in Children Under 12 Years With Moderate-to-Severe Atopic Dermatitis Included in the PEDISTAD Observational Registry. Pediatr Dermatol. Published online August 18, 2026. doi:10.1111/pde.70335

4. Ren T, Zhang B, Wang A, et al. Multimodal Ultrasound and Multispectral Imaging Combined With Investigator Global Assessment for Quantitative Evaluation of Rosacea: A Feasibility Study. Dermatologic Therapy, 2026, 4153163, 12 pages, 2026. doi:10.1155/dth/4153163

5. Kim JH, Choi WS. Skin Barrier and Dermal Edema Recovery Using Ideal-Sized Chitosan After Microneedle Radiofrequency: A Split-Face Case Report. J Cosmet Dermatol. 25, no. 8 (2026): e71131, doi:10.1111/jocd.71131