Rosacea is More than Just a Red Face: Microbotox's Role in Minimizing Enlarged Facial Pores for a Rosacea Patient

  • Adianto Jaya Nagara Department of Dermatology and Venereology, Medical Faculty of Andalas University / M. Djamil Hospital Padang
  • Satya Wydya Yenny Department of Dermatology and Venereology, Medical Faculty of Andalas University / M. Djamil Hospital Padang
  • Yola Fadhilla Department of Dermatology and Venereology, Medical Faculty of Andalas University / Achmad Mochtar Hospital Bukittinggi
  • Lilik Norawati Department of Dermatology and Venereology, Gatot Soebroto Army Central Hospital
  • Abraham Arimuko Department of Dermatology and Venereology, Gatot Soebroto Army Central Hospital
Keywords: Botox, Enlarged Facial Pore, Microbotox, Rosacea


Enlarged facial pores are a cosmetic concern and a prominent feature of skin aging that impacts patient quality of life. Microbotox has emerged in multiple studies as a solution for reducing pore size and improving skin texture. A case of 29 years old female with papulopustular rosacea and enlarged skin pores was reported. From the patient's anamnesis, it was found that the patient has been complaining of a reddish patch with pimples on the nose and both cheeks for the past 4 years. The patient has also had enlarged pores on both cheeks for the past 3 years. On dermatologic state there were erythematous macule, erythematous papules and enlarged pores on both of the cheek. Global Flushing Severity Score (GFSS) was 3, Investigator’s Global Assessment (IGA) of Rosacea Severity for papules and pustules is grade 2 and erythema grade 2. Visual Assessment for Pore was 6. Patient received a single session of microbotox. Dermoscopy examination showed linear vessels (telangiectasia), a pustule, and also follicles filled with sebum. Follow up of the patient was done for 6 weeks. Patients reported a decrease in issues such as flushing, papules, pustules, and erythema. A noticeable improvement in pore size was also observed. This action can be repeated every 3 months to maintain clinical improvement and good skin texture. Botulinum toxin exhibits a satisfying level of efficacy and safety in rosacea treatment. A single microbotox session proves to be a safe and effective approach for reducing facial pore size, along with notable improvements in skin texture.


Ahmed El Attar, Y., & Nofal, A. (2021). Microbotox for the treatment of wide facial pores: A promising therapeutic approach. Journal of cosmetic dermatology, 20(5), 1361-1366.

Babadjouni, A., Phong, C. H., Raffi, J., & Mesinkovska, N. A. (2022). Turning Down the Fire: The Role of Botulinum Toxin Microdroplets in Refractory Rosacea Erythema. SKIN The Journal of Cutaneous Medicine, 6(5), 437-440.

Bernstein, E. F., & Kligman, A. (2008). Rosacea treatment using the new‐generation, high‐energy, 595 nm, long pulse‐duration pulsed‐dye laser. Lasers in Surgery and Medicine: The Official Journal of the American Society for Laser Medicine and Surgery, 40(4), 233-239.

Del Rosso, J. Q., Gallo, R. L., Tanghetti, E., Webster, G., & Thiboutot, D. (2013). An evaluation of potential correlations between pathophysiologic mechanisms, clinical manifestations, and management of rosacea. Cutis, 91(3 Suppl), 1-8.

Hanna, E., Xing, L., Taylor, J. H., & Bertucci, V. (2021). Role of botulinum toxin A in improving facial erythema and skin quality. Archives of Dermatological Research, 1-10.

Kim, B. Y., Choi, J. W., Park, K. C., & Youn, S. W. (2013). Sebum, acne, skin elasticity, and gender difference–which is the major influencing factor for facial pores?. Skin Research and Technology, 19(1), e45-e53.

Kim, M. J., Kim, J. H., Cheon, H. I., Hur, M. S., Han, S. H., Lee, Y. W., ... & Ahn, K. J. (2019). Assessment of skin physiology change and safety after intradermal injections with botulinum toxin: a randomized, double-blind, placebo-controlled, split-face pilot study in rosacea patients with facial erythema. Dermatologic Surgery, 45(9), 1155-1162.

Lee, S. J., Seok, J., Jeong, S. Y., Park, K. Y., Li, K., & Seo, S. J. (2016). Facial pores: definition, causes, and treatment options. Dermatologic Surgery, 42(3), 277-285.

Park, K. Y., Kwon, H. J., Kim, J. M., Jeong, G. J., Kim, B. J., Seo, S. J., & Kim, M. N. (2018). A pilot study to evaluate the efficacy and safety of treatment with botulinum toxin in patients with recalcitrant and persistent erythematotelangiectatic rosacea. Annals of Dermatology, 30(6), 688-693.

Qiu, W., Chen, F., Feng, X., Shang, J., Luo, X., & Chen, Y. (2023). Potential role of inflammaging mediated by the complement system in enlarged facial pores. Journal of Cosmetic Dermatology.

Ren, K., Liu, H., Li, B., & Zhou, B. (2022). Fractional microneedle radiofrequency treatment for enlarged facial pores: A real‐world retrospective observational study on 75 patients. Journal of Cosmetic Dermatology, 21(12), 6742-6753.

Rho, N. K., & Gil, Y. C. (2021). Botulinum neurotoxin type A in the treatment of facial seborrhea and acne: evidence and a proposed mechanism. Toxins, 13(11), 817.

Shah, A. R. (2008). Use of intradermal botulinum toxin to reduce sebum production and facial pore size. Journal of drugs in dermatology: JDD, 7(9), 847-850.

Shanler, S. D., & Ondo, A. L. (2007). Successful treatment of the erythema and flushing of rosacea using a topically applied selective α1-adrenergic receptor agonist, oxymetazoline. Archives of dermatology, 143(11), 1369-1371.

Steinhoff, M., Buddenkotte, J., Aubert, J., Sulk, M., Novak, P., Schwab, V. D., ... & Voegel, J. J. (2011, December). Clinical, cellular, and molecular aspects in the pathophysiology of rosacea. In Journal of Investigative Dermatology Symposium Proceedings (Vol. 15, No. 1, pp. 2-11). Elsevier.

Zhang, H., Tang, K., Wang, Y., Fang, R., & Sun, Q. (2021). Use of botulinum toxin in treating rosacea: a systematic review. Clinical, Cosmetic and Investigational Dermatology, 407-417.

How to Cite
Jaya Nagara, A., Wydya Yenny, S., Fadhilla, Y., Norawati, L., & Arimuko, A. (2024). Rosacea is More than Just a Red Face: Microbotox’s Role in Minimizing Enlarged Facial Pores for a Rosacea Patient . Journal La Medihealtico, 5(1), 34-39.