A review of 19 studies suggests the treatment improves scar quality and patient satisfaction by reducing tension on healing wounds.

Botulinum toxin type A may improve the aesthetic outcome of new scars in patients prone to abnormal scarring, according to a study published in Plastic and Reconstructive Surgery.

“It appears to be a promising tool for scar prevention and scar quality improvement,” says Carlos Zavaleta-Corvera, MD, lead author of the study, in a release.

Study Results and Mechanism

Researchers reviewed 19 studies involving 686 patients and found that botulinum toxin type A is associated with improved scar quality, narrower scars, and higher patient satisfaction across several rating scales.

According to the study, the treatment may improve scar appearance through two primary mechanisms:

  • Relaxing muscles near the wound to reduce tension during healing.
  • Reducing inflammation to promote smoother skin recovery.

The potential value of this treatment is especially relevant for areas exposed to frequent movement, such as the face, neck, chest, abdomen, and the area surrounding the eyes, says Zavaleta-Corvera in a release.

Clinical Considerations and Safety

The study notes that approximately 100 million people develop new scars annually, including 11 million abnormal scars such as hypertrophic scars and keloids. These can cause limited movement and emotional distress in addition to cosmetic concerns.

While the findings are positive, botulinum toxin type A is not specifically FDA approved for scar treatment, making its use for this purpose off-label. In the reviewed studies, side effects were described as minimal and temporary, including injection-site pain, itching, and headache. No serious adverse effects were reported.

“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,” says Zavaleta-Corvera in a release.

The authors conclude that while the treatment appears to be a safe option for new scars, further research is necessary to develop specific clinical recommendations and identify which patient populations will benefit most.

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