New Acne Study Shows 40% Reduction in Sebum Using Transdermal Botulinum Toxin Application

Botulinum toxin type A has increasingly been used in aesthetic dermatology to improve skin quality and reduce sebaceous gland activity, particularly in patients with oily or acne-prone skin. Traditionally, these effects are achieved through intradermal microinjections, which can decrease sebum production, refine pore appearance, and improve skin texture. However, injection-based delivery may cause discomfort, transient erythema, bruising, swelling, and, in rare cases, unintended muscular effects due to toxin diffusion.

As a result, there is growing interest in noninvasive delivery methods that maintain clinical efficacy while improving patient comfort and safety. A new study evaluated the clinical efficacy and tolerability of transdermal delivery of botulinum toxin using Transdermal Application (TDA) technology via the DERMADROP MED device in patients with oily and acne-prone skin.¹

TDA Technology

The intervention involved needle-free transdermal application of botulinum toxin type A (25 IU of Bocouture, 150 kDa) using the DERMADROP MED system according to a standardized BIOBOTOX protocol. The technology utilizes oxygen-assisted microjet propulsion combined with a proprietary lipophilic–hydrophilic carrier matrix (LP3) to deliver active compounds across the epidermal barrier. The carrier system transiently modulates lipid organization within the stratum corneum, creating reversible diffusion pathways, while oxygen-driven microconvective transport enhances penetration into the superficial dermis and follicular structures. This dual mechanism allows dermal delivery without disrupting skin integrity or causing mechanical trauma.²

“Owing to its pain-free application profile and the absence of posttreatment downtime, it has gained traction among patients seeking efficacious yet minimally invasive therapeutic approaches,” the study authors noted.

Trial Design and Treatment Course

This single-center observational study was conducted in Barcelona, Spain, and included 19 participants aged 20 to 50 years; 15 were women and 4 were men. All patients had clinical features consistent with seborrheic or acne-prone skin, including excessive sebum production, enlarged pores, and frequent acneiform eruptions.

Prior to treatment, participants underwent standardized preparation including facial cleansing, skin acclimatization, antiseptic preparation, and gentle microdermabrasion to remove surface keratin and sebum. The botulinum toxin formulation was then delivered via a high-velocity microjet for approximately 12 minutes across multiple facial regions, including the forehead, cheeks, periorbital area, nasal dorsum, and chin. The procedure was followed by application of a hydrating mask and standardized posttreatment care instructions.

Clinical outcomes were assessed using a combination of objective and subjective measures at baseline, 2 weeks after treatment, and 4 weeks posttreatment. Objective sebum production was measured with a Sebumeter, while skin changes were documented through standardized 2D and 3D imaging. Subjective outcomes were assessed using two validated patient-reported outcome instruments: the Oily Skin Impact Scale (OSIS), which evaluates the psychosocial burden of oily skin, and the Oily Skin Self-Assessment Scale (OSSAS), which measures perceived oiliness across visual, tactile, and sensory domains.

Results

The results demonstrated statistically and clinically meaningful improvements in sebaceous activity and perceived skin quality. Quantitative Sebumeter measurements showed reductions in surface oiliness across all measured facial regions. The most pronounced and statistically significant decrease occurred in the forehead, where mean sebum levels declined from 166.75 mg/cm² at baseline to 100.19 mg/cm² at 2 weeks, representing a 39.9% reduction (p < 0.001). Additional reductions were observed in the cheeks, chin, and nasal regions, ranging from 25.9% to 34.1%, although these changes did not reach statistical significance.

Patient-reported outcomes also showed significant improvements. On the OSIS scale, scores in the “Annoyance” domain decreased by approximately 58%, and “Self-Image” scores improved by 54%. The largest reductions were observed in measures of frustration and annoyance related to facial oiliness, each decreasing by more than 3 points on the 10-point scale. Similarly, OSSAS results demonstrated significant improvements across visual, sensory, and tactile perceptions of oiliness. Visual assessment scores declined by 48%, sensory perception scores by 57%, and tactile scores by 49%. The blotting paper test, which reflects perceived oil production on the forehead, improved by 3.44 points, while overall perceived oiliness improved by nearly four points on average.

Treatment tolerability was excellent. Patients consistently reported that the procedure was painless and comfortable, with no procedure-related erythema, edema, bruising, or downtime. No adverse events were reported during the study period, and patient satisfaction was high. Many participants also described secondary benefits such as improved skin luminosity, smoother texture, and reduced reliance on cosmetic makeup. Some patients noted improvements in pigmentation irregularities and under-eye darkness, although these outcomes were exploratory and not predefined endpoints.

Conclusion

Overall, this study provides preliminary evidence supporting botulinum toxin delivery via TDA technology as a safe and effective noninvasive approach for managing oily and acne-prone skin. The method demonstrated measurable reductions in sebum production, improvements in skin quality, and substantial patient satisfaction without the discomfort or risks associated with injectable treatments. However, the authors note limitations including the small sample size, observational design, and relatively short follow-up period. Larger randomized controlled trials with longer follow-up are needed to confirm efficacy, determine optimal dosing and treatment intervals, and further explore the mechanism of action of TDA-based delivery systems.

References

1. Schulz S, Lamprecht S. Transdermal Delivery of Botulinum Toxin for the Management of Oily and Acne-Prone Skin Using TDA Technology. J Cosmet Dermatol. 2026;25(2):e70656. doi:10.1111/jocd.70656

2. Alvarez-Román R, Naik A, Kalia YN, Guy RH, Fessi H. Enhancement of topical delivery from biodegradable nanoparticles. Pharm Res. 2004;21(10):1818-1825. doi:10.1023/b:pham.0000045235.86197.ef