Revolutionising Scar Care: Botulinum Toxin Type A for Facial Scar Management

Original Article: Effects of botulinum toxin type A in the prevention and treatment of facial hypertrophic scars: A meta-analysis

What are the key takeaways of this article?

Facial trauma often leads to surgical interventions for tissue repair, which may result in hypertrophic scarring. These scars not only negatively impact the appearance but also jeopardise the psychological well-being of patients. Despite the availability of various treatments for hypertrophic scars, such as stem-cell therapy, cryotherapy, steroid injections, and laser treatment, their efficacy remains variable and inconsistently acknowledged. In recent years, injections of botulinum toxin type A (BTX-A) have emerged as a potentially effective method for both preventing and treating hypertrophic scars. BTX-A functions by inhibiting acetylcholine release, consequently reducing muscle contraction, and skin tension during wound healing. This reduction in tension is believed to decrease collagen formation and inhibit fibroblast proliferation, key mechanisms in scar formation. Therefore, this study aims to evaluate the efficacy of BTX-A in the treatment of facial hypertrophic scars.

A meta-analysis was conducted, encompassing 17 high-quality randomised control trials involving 1605 patients who underwent facial cosmetic surgery. Among these patients, 801 received BTX-A injections before surgical incision closure, forming the experimental group, while 804 comprised the control group. The evaluation metrics included Visual Analog Scale (VAS) scores, Vancouver scar scale (VSS) scores, scar width measurements, and overall effectiveness assessments. The analysis revealed statistically significant differences favouring the experimental group across all parameters. Specifically, the experimental group exhibited lower VAS and VSS scores, narrower scar widths, and higher overall effectiveness compared to the control group.

The findings highlight the efficacy of BTX-A in alleviating pain, reducing scar hypertrophy and width, and improving overall scar management in facial hypertrophic scars. Its mechanism of action involves the suppression of fibroblast proliferation and collagen secretion, as well as, the acceleration of fibroblast apoptosis, ultimately preventing scar formation.

While the study provides compelling evidence for the effectiveness of BTX-A in treating facial hypertrophic scars, further high-quality basic and clinical trials are warranted to validate its clinical value comprehensively. Additionally, exploring the long-term effects and optimal dosages of BTX-A in scar prevention and treatment will be essential for enhancing patient outcomes.

All in all, BTX-A presents a promising therapeutic option for patients with facial hypertrophic scars, offering not only symptomatic relief but also tangible improvements in scar appearance. Continued research efforts are imperative to establish BTX-A as a standard adjunctive therapy in scar management protocols, ultimately benefiting patients worldwide.

Publication Date: April 20th, 2024

Reference: Lin, J., & Wang, X. (2024). Effects of botulinum toxin type A in the prevention and treatment of facial hypertrophic scars: A meta-analysis. International Wound Journal, 21(3), e14796. https://doi.org/10.1111/iwj.14796

Summary By: Sascha Azoulay