The Role of Botulinum Toxins in Wound Management and Scar Revision

Abstract

Botulinum toxin A (BoTA) has proven a safe and effective treatment across a wide variety of medical and cosmetic applications. Recently, studies have explored the use of BoTA to optimize scar formation by reducing the dynamic tension under which traumatic and surgical wounds heal via chemodenervation of underlying muscles. This article reviews advances focusing on the use of BoTA in wound management and scar revision. Several prospective randomized controlled trials provide evidence that BoTA has a positive effect on wound healing and scar formation. This effect extends beyond its chemodenervative properties to include reducing pro-fibrotic factors and minimizing fibroblast growth and differentiation to better prevent pathological scarring. Botulinum toxin is a safe and efficacious adjunct to other interventions intended to optimize scar appearance in traumatic or surgical wounds. Questions remain regarding the optimal technique, timing, and dosing for BoTA administration for ideal wound healing.