Botulinum toxin type A, or Botox, commonly known for its use in wrinkle treatment, may also help some new scars heal more aesthetically in patients prone to abnormal scarring, according to a study in the July issue of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS).
“It appears to be a promising tool for scar prevention and scar quality improvement,” said Carlos Zavaleta-Corvera, MD, MSc, MRes, of Universidad Científica del Sur in Lima, Peru, lead author of the study.
Why reducing scars matters
Scars are not only a cosmetic concern. Depending on where they form and how they heal, scars can cause limited movement and emotional distress. Abnormal scars, which include thick, raised scars, such as hypertrophic scars and keloids, can be especially difficult for patients.
The study notes that about 100 million people develop new scars each year, including approximately 11 million abnormal scars.
Study findings
Researchers reviewed 19 studies involving 686 patients. It found the treatment is associated with improved scar quality, narrower scars and higher patient satisfaction across several commonly used scar-rating scales.
It may help improve the appearance of scars in two ways: By relaxing nearby muscles, which can reduce tension on a healing wound. It may also reduce inflammation, promoting smoother healing.
“Its potential value is especially relevant to areas exposed to a lot of movement such as the face, neck, chest, abdomen or area surrounding the eyes,” Dr. Zavaleta-Corvera said.
A potential lower-cost solution
Botulinum toxin type A may also be a more cost-effective treatment for new scars prone to abnormal scarring. The injections could create a better healing environment as the scar begins to form. Other scar-reducing treatments can be added, if necessary.
What patients should know
Botulinum toxin type A is not specifically FDA approved as scar treatment, so use for this purpose is considered off-label. Patients should talk with a board-certified plastic surgeon about their medical history, scar risk and available options before considering treatment.
In the studies reviewed, side effects are described as minimal and temporary, with no serious adverse effects reported. Possible side effects include injection-site pain, itching and headache. Patients with certain neuromuscular conditions or swallowing or breathing problems may face higher risks and should discuss those risks carefully with a physician.
“Our findings suggest botulinum toxin type A might help improve scar quality, reduce scar width, prevent abnormal scarring and increase patient satisfaction without serious adverse effects,” Dr. Zavaleta-Corvera said.
Findings are promising, but more research needed
The study concluded that botulinum toxin type A appears to be a promising and safe option for new scar treatment, but the authors caution that more research is necessary. More studies are needed to see which patients are most likely to benefit and to develop recommendations.
For patients prone to abnormal scarring, the findings suggest a potential future option that may aid early healing, while still leaving room for established scar treatments when needed.
Plastic and Reconstructive Surgery® is published by Wolters Kluwer.
Click here to read “Efficacy and Safety of Botulinum Toxin Type A for Pathological Scar Prevention: A Systematic Review and Meta-Analysis”
Article: “Efficacy and Safety of Botulinum Toxin Type A for Pathological Scar Prevention: A Systematic Review and Meta-Analysis” (doi: 10.1097/PRS.0000000000012631)
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