Comparison of Intradermal Versus Microneedling-Assisted Botulinum A Toxin Injection for Enlarged Facial Pores: A Randomized Clinical Trial.

[BACKGROUND] Enlarged facial pores are a prevalent cosmetic concern affecting many individuals. Traditional treatments include topical agents and laser therapies, but recent advancements have introduced intradermal and microneedling-assisted Botulinum toxin type A (BoNTA) injections as promising alternatives. This study aims to compare the efficacy of these two methods in reducing the size of enlarged facial pores.

[METHODS] This randomized clinical trial was conducted at a referral centre in Iran. Thirty patients aged 25-60 years with enlarged facial pores were enrolled. Patients were randomized to receive intradermal BoNTA injections on one side of the face and microneedling-assisted BoNTA injections on the other side. Dermoscopic evaluation and physical examination were performed at baseline and 1-month post-treatment. Improvement in pore size was assessed by three blinded dermatologists using the Quartile Improvement Scale (QIS), and patient satisfaction was measured using the Likert scale.

[RESULTS] The average age of participants was 34.2 years, with 29 females and one male. Dermoscopic and physical examination scores showed no significant difference between the two treatment modalities for both cheek and nose areas (p > 0.05). Patient satisfaction scores were also comparable between the two sides (p = 0.13). Both treatments effectively reduced pore size, but no statistically significant difference was observed between intradermal and microneedling-assisted BoNTA injections.

[CONCLUSION] Both intradermal and microneedling-assisted BoNTA injections are effective in treating enlarged facial pores, with no significant difference in efficacy. These findings provide flexibility for dermatologists in selecting the appropriate treatment method based on patient preferences and clinical considerations.