Wonderful question. I've encountered this question about having breakouts in the area of Botox injections in my own practice in Modesto, California about 3 times. So this is rare. The world of medicine is complex, and sometimes it seems strange. I have not had a case of the "man made pore" - so I can't address that question except to speculate that it may be a scar of sorts or somehow related to a cyst? I've had an experience where there was a reddish - pimple like reaction to only one of my needle pokes. I suspect in that patient that there was an underlying infection in that area - such a pimple - which then got exacerbated when I decided to inject Botox too close to that area. Botox injections are tricky, we want our injections to be in strategic places, but sometimes in our patients, blemishes and veins get in the way of an ideal placement - and thus I have to compromise in my decision and Botox strategy.Regarding the break-outs in the Botox areas. For some of my patients, I've come to realize that they are sensitive to some of the antiseptic methods I use to help prevent infections from the Botox procedure. Sometimes they are allergic to the antiseptic. There are various ones available out there and perhaps having your injector switch to a different antiseptic could help. And there's the possibility that the actual needle poke - which is a very mild form of skin trauma - could incite a inflammatory process.Ironically (to your question of why does Botox cause more blemishes), I've found most of the time that Botox helps calm down inflammation in an area of skin. This may be due to reduced sweating or a direct effect on rashes and pimples by Botox. Also, Botox sometimes shrinks pores as with what we've seen with meso-Botox.Thank you for your question, I'm just answer from my own personal experience as a Botox injector.
