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This is a normal reaction, and these spots will eventually flake off, revealing clearer skin beneath

For example, botulinum neurotoxin is associated with a hemagglutinin complex or other protein complexes that either bind to specific receptors on the enterocyte luminal cell membrane or disrupt the junctional protein E-cadherin to open the paracellular spaces for the absorption of the toxin [83]

M.NamasivayamP.NapisS.HoC

Inflammatory cytokines, including TNF- and IL-6, stimulate the c-Jun amino-terminal kinase (JNK) and I-kB kinase-b/nuclear factor-kB (NF-kB) paths in insulin-sensitive organs and inhibit insulin signaling [397]

Start conservatively at 0.25 mg daily for the first week to assess tolerance before increasing to 0.5 mg if needed