Improving the Appearance of Surgical Facial Scars With IncobotulinumtoxinA and Microneedling.

Abstract

The appearance of post-surgical scars on the face is a major concern for surgeons and a source of anxiety for patients after Mohs surgery due to nonmelanoma skin cancer (NMSC). The objective of this retrospective study was to assess the effectiveness of combining incobotulinumtoxinA and microneedling to improve the appearance of post-operative facial scars. Enrolled subjects underwent surgical removal of facial NMSCs followed by flap reconstruction by the same surgeon during 2014 (n=35) and 2015 (n=35). Sutures were removed 7 days after the procedure. Subjects treated during 2014 received no additional treatment and served as a control group. Subjects treated during 2015 also received micro-doses of incobotulinumtoxinA along the scar border and microneedling of the surgical area. Microneedling was repeated after 15 days. Scar severity was determined by the surgeon and an independent dermatologist using the modified Vancouver Scar Scale (VSS) scores on day 7 and day 30 following suture removal. Patient Satisfaction Scale scores were also determined using a 5-point scale on day 30. Mean (SD) VSS scores were 10.4 (1.14) on day 7 among treated subjects vs. 9.5 (1.88) among control subjects (P<0.05). On day 30, mean VSS scores had decreased to 1.1 (0.89) for treated subjects vs. 7.6 (1.72) for control subjects (P<0.05). Patient Satisfaction Scores were significantly higher among treated patients vs control subjects (4.45 vs 3.14; P<0.001). The use of incobotulinumtoxinA is a promising therapeutic option for improving scar appearance. Combined with microneedling, it significantly reduced VSS scores and improved overall satisfaction of treated subjects following surgery for NMSCs. J Drugs Dermatol. 2020;19(6): doi:10.36849/JDD.2020.4772.