Resumo

Objectives: To assess the efficacy and safety of incobotulinumtoxinA (incoBoNT/A) as an adjunctive treatment for jawline acne. Introduction: Acne vulgaris is a common inflammatory disorder of the pilosebaceous unit with a multifactorial pathogenesis. Current management strategies aim to address the underlying pathogenic mechanisms of acne, including topical agents, systemic therapies, and procedural modalities. Botulinum toxin type A (BoNT/A) has gained attention for its potential benefits in reducing sebum production, pore size, and acne severity. However, clinical effects of acne management remains limited. Materials / method: A split-face, randomized controlled trial was conducted in 30 participants with mild to moderate jawline acne. Each participant received topical benzoyl peroxide/adapalene (BP/ADP) on both sides; one randomized side additionally received intradermal incoBoNT/A. Assessments were performed at baseline and at 1, 2, 3, and 4 months. Subjective evaluations consisted of acne lesion counts, the Investigator Global Assessment (IGA), patient satisfaction, and adverse events. Objective measures included pore volume and sebum excretion. Results: Comedo counts were significantly lower on the incoBoNT/A-treated side at 1 and 4 months (p=0.003 and 0.036), whereas inflammatory lesions decreased similarly on both sides. Both techniques demonstrated significant improvement from baseline at all follow-up visits. The incoBoNT/A-treated side showed significantly greater reductions in pore volume across all visits (p<0.05), while sebum production was significantly reduced at month 3 (p=0.021). No adverse events related to incoBoNT/A were observed, and patient satisfaction scores were significantly higher on the incoBoNT/A-treated side. Conclusion: Intradermal incoBoNT/A combined with topical BP/ADP demonstrated favorable efficacy and safety in the treatment of mild-to-moderate jawline acne. By modulating cholinergic signaling within sebaceous glands, botulinum toxin may provide a complementary mechanism targeting sebum production beyond conventional topical therapy. These findings support the emerging concept of sebaceous gland neuromodulation as a potential therapeutic strategy in acne management.