New York: Botox has been found to be helpful in lessening the scar tissue of facial wounds.
Treating a wound prevents facial movements making the scar worse and reducing the need for cosmetic surgery later, according to research carried out by the Mayo Clinic.
The researchers found that an injection with botulinum toxin at the site of a wound early on following an accident paralyses the area, creating a smooth surface in which the wound can heal.
This prevents muscle movement from wrinkling the wound site, allowing for a flat surface for healing and leaving a smoother final scar. The same process also could work if an unsightly older scar is surgically removed, and then botulinum toxin is injected into the wound at the time of the scar revision surgery.
Repeated muscle movements can distort wounds and healing, resulting in inflammation which means a patient ends up with a thicker or wider scar. Scar reduction techniques designed to reduce the effects of muscle tension on a wound and to improve the final appearance of the scar include special stitches that pull the wound together and local flaps that bring additional skin into the wound bed.
The researchers undertook this trial after seeing significant results in wound healing with botulinum toxin in a basic research study. In the human trial, the researchers recruited patients with forehead wounds from trauma such as auto accidents, or from surgery, such as skin cancer excision. Forehead wounds were selected for study as they are a frequent site of facial scarring. Patients were randomly selected to receive injections with botulinum toxin or with saline, a benign substance used for comparison. All 31 patients’ wounds were photographed at the time of the initial treatment and injection and again six months after initial treatment. Two experienced facial plastic surgeons rated the wounds’ appearance on a scale in which 0 was the worst appearance and 10 was the best. These assessors were not informed about which patients received which treatment. The researchers averaged the ratings of the two surgeons for a final scar appearance score for each patient’s wound. They found that the facial plastic surgeons rated the cosmetic results of the wounds injected with botulinum toxin more favorably than the wounds injected with saline. Median scores for wounds injected with botulinum toxin were 8.9, versus a median score of 7.1 for those injected with saline, a significant difference in appearance, according to the researchers.
Although injections with botulinum toxin would be available at local physicians’ offices throughout the country, the injections are not yet approved for this use by the Food and Drug Administration (FDA).
The next step in this research would be to conduct a Phase III, multicenter trial with hundreds of patients to determine the appropriate dosage of the botulinum toxin; discover whether the injections are useful for better healing of scars elsewhere on the body, such as heart surgery wounds; and to provide more findings to present to the FDA to seek approval for this treatment.