Botulinum toxin type A (BTX-A) to improve the treatment of keloid and hypertrophic scars: A double-blinded randomized clinical trial

Background: Keloid and hypertrophic scars are the results of abnormal skin cells proliferation that usually cause major physical, psychological and cosmetic problems. However, there is no effective method for eliminating this scars yet. Recent reports suggested that BTX-A improves wound healing. However, there is no comprehensive study to assess the efficacy of BTX-A injection for treatment of keloid and hypertrophic scars. Aim: This study aims to investigate whether BTX-A injection improves the keloid and hypertrophic scars treatment or not. Methods: Ten patients with keloid or hypertrophic scar lesions were enrolled in this study and randomized into two groups (injected by BTX-A or placebo). Injections were applied at one-month intervals for a total of three months. All the patients were followed up for at least six months. Scars were assessed by mVSS (modified Vancouver Scar Scale) and an independently blinded evaluator with standardized photographs. Results: The study was completed with ten patients at the six months follow up visits in the treatment group. BTX-A reduced (not significantly, p>0.09) mVSS including pliability, vascularity, pigmentation, and height, but did not affect the pruritis and pain. Conclusion: It can be concluded in this study that BTX-A can reduce some parameters of mVSS and may be a suitable compound for the treatment of keloid and scar tissue.