Efficacy of Incobotulinumtoxin A on Maskne: Evaluation in a Prospective, Single-Center, Placebo-Controlled,...

Skin quality affects both external perception and psychological well-being. A decline in skin quality, as seen in acne tarda or due to prolonged mask use, especially in healthcare professionals, can be reflected in emergent perceptual category (EPC) parameters. During the COVID-19 pandemic, this led to an increase in mask-induced acneiform eruptions, commonly referred to as "maskne." Intradermal application of Incobotulinumtoxin A (INCO) may improve skin quality, but data in maskne patients are limited.

To evaluate the efficacy of intradermal INCO on skin quality in women with maskne.

In a prospective, randomized, double-blind, placebo-controlled trial, 36 women with maskne received intradermal INCO (20 U) or placebo (2:1) in the mid and lower face. Skin roughness (SEr), sebum level, pore size, and erythema index were measured over 112 days using biophysical tools. Patient and expert assessments were recorded via Global Impression of Change Scale (GICS).

Thirty-three participants completed the study. The INCO group showed significantly greater SEr improvement than placebo on days 28, 56, 84, and 112. Sebum level decreased significantly by day 28 (-19.27 μg/cm² vs. +1.27 μg/cm² in placebo; p < 0.001). Pore size differed significantly at days 28 and 56. Erythema decreased in both groups, with greater reduction in the INCO group (-43.81 vs. -3.27; p = 0.041). Both patients and investigators reported improved skin quality in the treatment group.

Intradermal injection of INCO represents a promising approach for managing mask-associated skin conditions ("maskne"). While further investigations are necessary to fully establish its benefits, the present study offers encouraging evidence supporting its efficacy.