Journal of

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Background and Aim: Hypertrophic scars are highly resistant to the treatment and have a high recurrence rate. Affected patients suffer from aesthetic and functional complications, which may influence their quality of life. Nowadays, various therapeutic modalities have been used in the treatment of hypertrophic scars, but patients' problems remain because of high recurrence rate. This study evaluated the efficacy of intralesional injection of botulinum toxin A in the treatment of hypertrophic scar lesions.

Methods: This randomised controlled trial was performed during 2014 and 2015. Each patient`s lesion was randomly allocated in ine of the two arms of the study: one half of the lesion received monthly 8 IU/cm³ of 200 IU/ml intralesional botulinum toxin A (Dysport, Ipsen Biopharma Ltd., UK) and the other half was injected with the same volume of normal saline. Injections were repeated three times. After 9 months, lesions were evaluated according to Vancouver scar scale.

Results: Twenty-one patients with a mean age of 27.2 years completed the study. In the intervention the mean lesions` pigmentation scale decrease to 0.73, vascularity to 0.9 and pliability to 0.98 (P<0.01), but there was no significant change in lesions height (P=0.32).

Conclusion: It seems that injection of botulinum toxin A in hypertrophic scar lesions acts as useful adjuvant for other treatment methods.

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Hypertrophic scars and keloids are fibrosis abnormalities associated with the accumulation of collagen and extra cellular matrix components. These scars are caused by abnormal wound healing, which may occur after skin injuries caused by surgery, trauma, burns, etc. and may have a large impact on the patients’ quality of life. Hypertrophic scars and colloids in addition to aesthetic problems can cause functional disruption due to tissue contraction and itching. Large numbers of research are currently being performed in the area of scar prevention or treatment, but since the physiopathological mechanisms of scar formation have not been fully elucidated, the current strategies are still unsatisfactory. In this review, we discuss the recent biological advances in scar formation and current and future strategies for the prevention and treatment of hypertrophic and keloid scars.