Intradermal Botulinum Toxin A on Skin Quality and Facial Rejuvenation: A Systematic Review and Meta-analysis

Area of Science:

• Dermatology
• Aesthetic Medicine
• Evidence-Based Practice

Background:

• Botulinum toxin A (BTxA) is a popular nonsurgical option for skin rejuvenation.
• Previous studies on intradermal BTxA efficacy for facial rejuvenation have yielded inconsistent results.
• A systematic review and meta-analysis with trial sequential analysis was conducted to evaluate intradermal BTxA.

Purpose of the Study:

• To systematically review and meta-analyze the efficacy and safety of intradermal botulinum toxin A for facial rejuvenation.
• To assess the impact of intradermal BTxA on various skin quality parameters.
• To determine the strength of evidence using trial sequential analysis.

Main Methods:

• PRISMA guidelines were followed for a comprehensive literature search from January 2008 to March 2023.
• Included human clinical trials and prospective cohort studies on healthy individuals seeking facial rejuvenation.
• Data extraction and quality assessment were performed by two independent reviewers.

Main Results:

• Ten studies (5 RCTs, 5 cohort studies; 153 participants) met inclusion criteria.
• Intradermal BTxA demonstrated positive effects on sebum production, pore size, erythema index, wrinkles, skin texture, elasticity, and facelift.
• Skin hydration did not show significant improvement, and all outcomes failed to reach the required information size in trial sequential analysis.

Conclusions:

• Intradermal BTxA shows potential benefits for multiple aspects of skin quality and facial rejuvenation.
• Current evidence, while positive, is limited by the insufficient information size from trial sequential analysis.
• Further high-quality research is essential to establish definitive conclusions on the efficacy and safety of intradermal BTxA for facial rejuvenation.