Abstract
Background: Skin aging is characterized by a gradual loss of tissue and organ function. Skin aging can be classified into two types: intrinsic aging, associated with the aging process itself, and extrinsic aging, which is linked to external factors. Microbotox—an intradermal injection of diluted botulinum toxin—has emerged as a promising technique for rejuvenation by improving skin texture, pore size, and sebum control. This review aims to provide a comprehensive overview of the microbotox technique in the context of skin aging, emphasizing its mechanisms, indications, and clinical outcomes.
Discussion: In Asia, intradermal injection of botulinum toxin or microbotox has been widely adopted. The technique involves injecting microdroplets of onabotulinumtoxin type A (ONA) into the intradermal layer at lower concentrations compared to conventional methods. Microbotox is highly sought after for its ability to improve skin texture, address enlarged pores, control sebum, and rejuvenate the skin without the stiffness often associated with conventional botox.
Conclusion: Microbotox provides multiple dermatological benefits, including improved skin texture, pore reduction, oil control, and fine line softening, with minimal side effects. As an intradermal technique, it offers a safer and subtler alternative to traditional botox. It provides rapid results lasting up to 3-4 months, making it a valuable tool in aesthetic dermatology. This has made microbotox one of the most popular skin rejuvenation treatments today.
References
- Liguori I, Russo G, Curcio F, et al. Oxidative stress, aging, and diseases. Clin Interv Aging. 2018;13:757–72.
- Glogau RG. Botulinum toxin. In: Kang S, Amagai M, Bruckner AL, et al, editors. Fitzpatrick’s dermatology. 9th ed. New York: McGraw Hill; 2019. p.3921–30.
- Kandhari R, Kaur I, Gupta J, Al-Niaimi F. Microdroplet botulinum toxin: A review. J Cutan Aesthet Surg. 2022;15(2):101–7.
- Samargandy S, Raggio BS. Chemical peels for skin resurfacing. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; [reviewed 2023 Oct 29; cited 2025 Mar 15]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK547752/
- Assa MCA, Fogaça A, Palermo E, et al. Global facial rejuvenation using a new cohesive, highly concentrated hyaluronic acid filler: A descriptive analysis of 35 cases. Cosmetics. 2023;10(4):1–9.
- Haykal D, Cartier H, Goldberg D, Gold M. Advancements in laser technologies for skin rejuvenation: A comprehensive review of efficacy and safety. J Cosmet Dermatol. 2024; 23(10):3078–89.
- Martina E, Diotallevi F, Radi G, Campanati A, Offidani A. Therapeutic use of botulinum neurotoxins in dermatology: Systematic review. Toxins (Basel). 2021;13(2):1–34.
- Choudhury S, Baker MR, Chatterjee S, Kumar H. Botulinum toxin: An update on pharmacology and newer products in development. Toxins (Basel). 2021;13(1):1–15.
- Rossetto O, Pirazzini M, Fabris F, Montecucco C. Botulinum neurotoxins: Mechanism of action. In: Whitcup SM, Hallet M, editors. Botulinum toxin therapy. Cham: Springer; 2021. p.35–48.
- Pirazzini M, Rossetto O, Eleopra R, et al. Botulinum neurotoxins: Biology, pharmacology, and toxicology. Pharmacol Rev. 2017;69(2):200–35.
- Field M, Splevins A, Picaut P, et al. Abobotulinumtoxina (Dysport®), onabotulinumtoxina (Botox®), and incobotulinumtoxina (Xeomin®) neurotoxin content and potential implications for duration of response in patients. Toxins (Basel). 2018;10(12):1–14.
- Seo KK. Multiple intradermal botulinum toxin injections. In: Seo KK, editor. Botulinum toxin for Asians. Singapore: Springer; 2017. p.135–9.
- Tamura B. Microbotox, mesobotox, botulinum toxin microdroplet. In: Issa MC, Tamura B, editors. Botulinum toxins, fillers and related substances. Cham: Springer; 2019. p.93–9.
- Wu WTL. Microbotox of the lower face and neck: Evolution of a personal technique and its clinical effects. Plast Reconstr Surg. 2015;136(5 Suppl):92S–100S.
- Fabi SG, Park JY, Goldie K, Wu W. Microtoxin for improving pore size, skin laxity, sebum control, and scars: a roundtable on integrating intradermal botulinum toxin type a microdoses into clinical practice. Aesthet Surg J. 2023;43(9):1015–24.
- Wu WTL. The microbotox technique. In: Tonnard P, Verpaele A, Bensimon R, editors. Centrofacial rejuvenation: Part II - the place of toxins and fillers in the modern plastic surgery practice. Stuttgart: Thieme; 2018. p.289–309.
- Purpera P, Baumann L. Botulinum toxin. In: Baumann LS, Rieder EA, Sun MD. editors. Baumann’s cosmetic dermatology. 3rd ed. New York: McGraw Hill; 2022. p.303–30.
- Pendit BU, Norawati L. Pedoman injeksi toksin botulinum. Jakarta: Perhimpunan Dokter Spesialis Kulit dan Kelamin Indonesia; 2022. Indonesian.
- Wu WTL. Skin resurfacing with microbotox and the treatment of keloids. In: Benedetto AV, editor. Botulinum toxins in clinical aesthetic practice. 3rded. London: Routledge; 2011. p.204–19.
- Bertossi D, Giampaoli G, Lucchese A, et al. The skin rejuvenation associated treatment—fraxel laser, microbotox, and low g prime hyaluronic acid: Preliminary results. Lasers Med Sci. 2019;34(7):1449–55.
- Diaspro A, Calvisi L, Manzoni V, Sito G. Microbotulinum: A quantitative evaluation of aesthetic skin improvement in 62 patients. Plast Reconstr Surg. 2020;146(5):987–94.
- Rahman E, Rao P, Philipp-Dormston W, et al. Intradermal botulinum toxin a on skin quality and facial rejuvenation: A systematic review and meta-analysis. Plast Reconstr Surg Glob Open. 2024;12(8):1–15.
- Zhang X, Cai L, Yang M, Li F, Han X. Botulinum toxin to treat horizontal forehead lines: A refined injection pattern accommodating the lower frontalis. Aesthet Surg J. 2020;40(6):668–78.
- Cao Y, Yang JP, Zhu XG, et al. A comparative in vivo study on three treatment approaches to applying topical botulinum toxin a for crow’s feet. Biomed Res Int. 2018;2018:1–9.
- Steinsapir KD, Rootman D, Hwang C. Cosmetic microdroplet botulinum toxin a forehead lift: a new treatment paradigm. Ophthalmic Plast Reconstr Surg. 2015;31(4):263–8.
- Diaspro A, Silenzi S. Microneedle for botulinum toxin: A randomized, case-control, single-blind study to assess clinical efficacy and patient satisfaction. Plast Reconstr Surg Glob Open. 2025;13(3):1–9.
- Shuo L, Ting Y, Kelun W, Rui Z, Hang W. Efficacy and possible mechanisms of botulinum toxin treatment of oily skin. J Cosmet Dermatol. 2019;18(2):451–7.
- Park JY, Cho SI, Hur K, Lee DH. Intradermal microdroplet injection of diluted incobotulinum toxin-a for sebum control, face lifting, and pore size improvement. J Drugs Dermatol. 2021;20(1):49–54.
- Attar YAE, Nofal A. Microbotox for the treatment of wide facial pores: A promising therapeutic approach. J Cosmet Dermatol. 2021;20(5):1361–6.
- Atwa EM, Nasr MM, Ebrahim HM. Evaluation of intradermal injection of botulinum toxin a for facial lifting. J Clin Aesthet Dermatol. 2020;13(12):22–6.
- Wanitphakdeedecha R, Yan C, Apinuntham C, et al. Intradermal micro-dosing of abobotulinum toxin a for face-lifting: How long does it last? Dermatol Ther (Heidelb). 2020;10(4):779–89.
- Sayed KS, Hegazy R, Gawdat HI, et al. The efficacy of intradermal injections of botulinum toxin in the management of enlarged facial pores and seborrhea: A split face-controlled study. J Dermatolog Treat. 2021;32(7):771–7.
Recommended Citation
Malinda, Ifen Ayu and Jusuf, Nelva Karmila
(2025)
"Skin Rejuvenation with Microbotox: A Review,"
Journal of General - Procedural Dermatology and Venereology Indonesia: Vol. 9:
Iss.
1, Article 10.
DOI: 10.7454/jdvi.v9i1.1218
Available at:
https://scholarhub.ui.ac.id/jdvi/vol9/iss1/10
Included in
Dermatology Commons, Integumentary System Commons, Skin and Connective Tissue Diseases Commons