ABSTRACT
All concentrations of tretinoin are useful in comedonal and inflammatory acne (0.05% or 0.1% cream is the maximal benefit).
Despite its benefits, tretinoin, as with other topical retinoids, has the potential to cause localized irritation. To minimize this response while maintaining clinical efficacy, tretinoin has been formulated in sponge like polymeric microspheres that encapsulate the active ingredient and deliver gradually and relatively selectively to the follicle. In comparison with a standard 0.025% cream, a tretinoin microsphere gel 0.1% formulation has been shown to be less irritant to normal skin and to cause significantly less erythema and dryness in patient with mild to moderate facial acne over a period of 12 weeks (54,55).
Sebum Regulator Intradermal Botulinum Toxin The use of intradermal botulinum toxin type A is a new technique. The purported mechanism of action of botulinum pore reduction can be postulated on the basis of its known neuromodulatory effects. A. Shah shows that intradermal botulinum toxin can be injected safely in the area of the forehead, medial cheek, and nose without complications. A treatment of intradermal botulinum toxin subjectively reduced skin oiliness and pore size in 17/20 patients at 1 month after injection (56).
