Microtox — sometimes called “mesotox” or “dermatox” — is a specific anti-wrinkle injection technique where small doses of diluted botulinum toxin are placed superficially in the dermis rather than deep into the muscle. The result is different from conventional muscle-relaxing injections: skin texture improves, pore size reduces, oil production decreases, and the overall complexion takes on a smoother, more refined quality without significantly affecting facial expression.
This is the “glass skin” look that’s increasingly requested at aesthetic clinics — that smooth, dewy, almost poreless quality associated with K-beauty and the curated complexions of skincare-focused celebrities. Microtox is one of the more effective treatments for achieving it, though the result is subtle and requires regular maintenance.
This guide covers exactly what Microtox does, who it suits, who it doesn’t, what to expect, and how it differs from conventional anti-wrinkle injections.
How Microtox differs from conventional anti-wrinkle treatment
Conventional anti-wrinkle injections work by relaxing facial muscles. The botulinum toxin is placed into specific muscle groups (forehead, glabella, crow’s feet) where it interrupts the signal between nerve and muscle. The muscle relaxes, and dynamic lines (the wrinkles that appear with facial movement) soften.
Microtox uses the same active ingredient but in a fundamentally different way:
Placement. Superficial, in the dermal layer just beneath the skin surface — not in the muscle below.
Dose. Diluted so that each micro-droplet contains a very small amount of toxin. The total dose used across a face is similar to or less than conventional treatment but distributed across many more injection points.
Mechanism. The toxin affects:
- The arrector pili muscles attached to hair follicles (small muscles that can affect skin texture)
- Sebaceous gland activity (the oil-producing glands)
- Eccrine sweat glands (reducing flushing and sweating)
- Capillary tone (reducing visible redness)
- Superficial muscle fibres without producing full muscle relaxation
Result. Improved skin texture, smaller-looking pores, reduced oiliness, less flushing, and an overall “polished” quality to the skin — without altering facial expression or dynamic line patterns.
For the broader topic of how botulinum toxin can be used in different ways, see our comprehensive anti-wrinkle injections FAQ.
What Microtox can address
The treatment is particularly useful for:
Enlarged pores on the cheeks, nose, and forehead. By relaxing the small muscles and reducing sebum production around the follicle, pore visibility decreases. Effect develops over 2-4 weeks.
Excessive oiliness producing shiny, greasy-looking skin throughout the day. Microtox reduces sebaceous gland activity, with patients typically noticing significantly less midday shine.
Fine surface lines without the deep dynamic wrinkles that conventional anti-wrinkle treatment addresses. The fine “crepiness” of mature skin or early ageing changes responds well to superficial dermal placement.
Facial flushing and rosacea-prone skin. The reduction in capillary reactivity can soften redness associated with rosacea or environmental triggers.
Mild acne. By reducing sebum production — the substrate that feeds the bacteria causing acne — Microtox can produce noticeable improvement in oily/acneic skin. It’s not a primary acne treatment but works well as adjunctive therapy.
Forehead expression lines for patients who don’t want full forehead muscle relaxation but want subtle softening. Particularly useful for patients with heavy brows or upper eyelids who’d be poor candidates for conventional forehead treatment.
Excessive forehead or facial sweating. The same effect that reduces oiliness also reduces sweat gland activity in the treated area.
What Microtox can’t do
The treatment doesn’t address:
- Deep dynamic wrinkles (forehead, glabella, crow’s feet) — these need conventional muscle-targeted treatment
- Volume loss — filler is required
- Pigmentation changes (sun damage, melasma) — these need laser or topical treatment
- Significant skin laxity — energy-based or surgical treatment required
- Acne scarring — texture-improving treatments like Morpheus8 or laser resurfacing
Microtox is a refinement treatment, not a transformation. Patients with substantial skin concerns typically need it as part of a broader treatment plan.
The procedure
Consultation. Assessment of your skin concerns, suitability, and goals. The treatment plan is determined based on which specific areas need addressing.
Preparation. Skin is cleansed thoroughly. Topical anaesthetic is usually not required — the injections are superficial and minimally uncomfortable. Some practitioners use cooling devices for added comfort.
The injection.
- Very fine 32G needle (one of the thinnest available)
- Small droplets of diluted toxin placed at multiple points across the treatment area
- Spacing approximately 1-2cm between injection points
- Typical full-face treatment involves 30-60 injection points
- Total procedure time 15-25 minutes
Immediate effects. Tiny bumps at each injection point that settle within 15-30 minutes. Minimal redness lasting 1-2 hours. Most patients return to normal activities immediately.
What to expect after treatment
Immediately: mild pinkness at injection points, tiny bumps that resolve quickly. Occasional small bruise.
Days 1-3: no visible change yet. The toxin is gradually taking effect.
Days 3-7: initial effects begin — slightly less oiliness, subtle skin smoothing.
Weeks 2-3: full effect develops. Pore visibility reduced, oiliness substantially decreased, skin texture more refined.
Weeks 3-12: stable result. The “glass skin” effect at its peak.
Months 3-4: effect begins to fade gradually. Maintenance treatment to sustain the result.
The treatment can be combined with conventional anti-wrinkle injections, dermal filler, and laser treatments in the same overall plan. Microtox is typically performed as a standalone session, with other treatments sequenced appropriately.
Aftercare
- Avoid lying flat for 4 hours after treatment
- Avoid touching or massaging the treated area for 24 hours
- Avoid strenuous exercise on the day of treatment
- Avoid heat exposure (sauna, steam, hot bath) for 48 hours
- Avoid other facial treatments (laser, microneedling) for 2 weeks
- Normal makeup application can resume after 4-6 hours
- Daily SPF as standard skincare
These precautions reduce the small risk of the product migrating to nearby muscles, which could affect facial expression in ways the patient doesn’t want.
For the broader aftercare framework that applies across injectable treatments, see our injectables aftercare guide.
How long the result lasts
The Microtox effect typically lasts:
- Forehead expression line softening: 2-3 months
- Pore reduction and texture improvement: 3-4 months
- Oil and sweat reduction: 3-5 months
- Flushing and redness improvement: 4-6 months
Maintenance treatment every 3-4 months sustains the result. With consistent treatment over time, some patients find the effect lasts slightly longer as the underlying tissue adapts.
Who is a good candidate?
The ideal Microtox candidate has:
- Enlarged pores particularly on the central face — cheeks, nose, forehead
- Excessively oily skin that doesn’t respond adequately to skincare alone
- Mild acne or acne-prone skin alongside oiliness
- Fine skin texture concerns rather than deep wrinkles
- Facial flushing or mild rosacea wanting reduction of redness
- Realistic expectations — refinement, not transformation
- Willingness to maintain the result with treatment every 3-4 months
Less suitable for:
- Patients wanting dramatic wrinkle reduction (conventional anti-wrinkle injection more appropriate)
- Patients with significant skin laxity (energy-based or surgical treatment needed)
- Patients with substantial acne scarring (texture-improving treatments more appropriate)
- Patients with very dry skin (Microtox may worsen dryness in some)
- Patients during pregnancy or breastfeeding
- Patients with neuromuscular disorders (myasthenia gravis, Lambert-Eaton)
- Patients with known allergy to botulinum toxin
Combining with other treatments
Microtox combines well with several other treatments to produce comprehensive results:
Microtox + conventional anti-wrinkle injection. Most common combination — Microtox addresses skin texture while conventional treatment addresses dynamic lines. Done in the same session.
Microtox + dermal filler. For patients needing volume restoration alongside skin quality improvement. Filler treats one set of concerns, Microtox another.
Microtox + Profhilo or polynucleotides. Layered skin quality improvement — Microtox addresses pore size and oiliness, biostimulators address dermal quality from a different angle. See our Profhilo guide for more.
Microtox + skin boosters. Similar layered approach for hydration and surface quality.
Microtox + laser treatment. Microtox for ongoing oil/pore management, laser for pigmentation and surface texture. Typically sequenced rather than performed simultaneously.
For the broader non-surgical rejuvenation context, see our non-surgical facelift hub.
Cost
Microtox at Centre for Surgery is priced per session. Full-face treatment typically costs from £350-£500 depending on the area treated and the number of injection points required.
Maintenance every 3-4 months. Over a year, total cost is typically £1,050-£1,500 for ongoing treatment.
Finance options through Chrysalis Finance, including 0% APR, are available across all treatment plans.
Risks and considerations
Common (mild and self-limiting):
- Pinkness at injection points for 1-2 hours
- Tiny bumps that resolve quickly
- Occasional small bruise
- Mild headache for 1-2 days (uncommon)
Less common:
- Asymmetry if injection points are unevenly placed
- Slight muscle weakness if injection placed too deep (resolves within weeks)
- Excessive dryness in patients with already dry skin
Rare:
- Allergic reaction to the toxin or carrier solution
- Brow ptosis if placement near the brow is too deep
- Eyelid drooping if treatment extends too close to the eye
A consultation with experienced injectors substantially reduces these risks through careful patient selection, conservative dosing, and precise placement technique.
Common questions
Will my face look frozen after Microtox?
No — that’s exactly what Microtox is designed to avoid. The placement is superficial enough that facial expression is largely preserved. You’ll still be able to raise your eyebrows, smile, and produce all normal expressions. The change is in skin quality, not muscle function.
How quickly will I see results?
Initial changes within 3-5 days. Full effect at 2-3 weeks.
Is the treatment painful?
Minimally — the fine needle and superficial placement make it less uncomfortable than conventional anti-wrinkle treatment for most patients. Topical anaesthetic isn’t usually needed.
Can I have Microtox alongside my regular anti-wrinkle injection?
Yes — many patients have both done together. Conventional treatment for forehead/glabella/crow’s feet, Microtox for cheek pores and oiliness.
Will it help with my acne?
For oily/acne-prone skin, yes — by reducing sebum production. For substantial active acne or acne scarring, Microtox is best as adjunctive rather than primary treatment.
What’s the difference between Microtox and mesotherapy?
Mesotherapy involves injecting cocktails of vitamins, minerals, antioxidants, and sometimes hyaluronic acid into the dermis. It addresses different concerns (hydration, nutrient delivery, sometimes hair restoration). Microtox is specifically diluted botulinum toxin for the effects listed above. The two are different treatments that occasionally appear together in marketing material.
How does Microtox compare with skin boosters like Profhilo?
They address different aspects of skin quality. Microtox reduces pore size and oiliness. Profhilo and similar biostimulators improve dermal hydration, elasticity, and collagen content. Many patients benefit from both, sequenced appropriately.
Can men have Microtox?
Yes — particularly beneficial for men with oily skin, enlarged pores, or rosacea. The treatment approach is similar to that for women.
What about patients with dry skin?
Microtox can worsen dryness in patients who already have very dry skin, since it reduces sebum production. For dry-skinned patients, hydration-focused treatments (Profhilo, polynucleotides, skin boosters) are typically more appropriate.
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