Through a question from a patient I ended up doing a search…. which got me to a study on Botox helping with keloids. (Don’t you love what you find when you ramble on the internet?) The topic? Can you treat keloids with Botox?
These are PubMed articles, so published medical studies. I found a meta-analysis from April 2019 in the Medical Science Monitor Journal (not one I typically read).
“Intralesional Injection of Botulinum Toxin Type A Compared with Intralesional Injection of Corticosteroid for the Treatment of Hypertrophic Scar and Keloid: A Systematic Review and Meta-Analysis”
A mouthful I know. I liked this because it was a meta analysis, looking at a bunch of prior studies. It also was comparing use of Botox versus using a steriod- which has been the traditional way to treat hypertrophic and keloid scars.
So what did they find?
- They looked at randomized controlled trials and prospective trials. (After screening thousands of articles, only 15 qualified. 15 clinical trials with 639 participants, published between 2006 and 2018 in seven different countries were identified, with a mean follow-up of 6 months.)
- Intralesional injections were done of Botox vs. placebo and Steroid vs placebo.
- the mean age of the patients was 33.7 years
- the most common site for hypertrophic scars and keloids being on the face (55.87%)
- Significant differences were seen
- The visual analog scale (where patients assess)
- Effective rate
- The width of scar
- The Vancouver Scar Scale (where the scar is evaluated with 4 parameters: melanin pigmentation, scar height, vascularity, and pliability.)
- Their conclusion? “Systematic review showed injection of intralesional Botox was MORE effective in treatment of hypertrophic scar than steroid or placebo.”
WOW. I already knew Botox helped with wrinkles, depression, and looking old. Had no idea it was good for bad scars too.
So how much Botox was used?
Each study varied.
- They tended to do about 15-20 units, though some varied it with the length of scar
- 15 units if less than 2cm, 30units if 2-4cm, and 45 units if longer than 4 cm.
Drawbacks?
- Most of the studies were on Asian patients, so it is unknown if the results would be true for everyone.
- Cost. Botox is much more expensive than steroids.
My thoughts?
I learned something today. The next time I see a keloid (which are thankfully rare), I will love to see if this helps. Keloids are tough to treat, and steroids give variable results. There is absolutely room for improvement.
For blogs on keloids, read HERE>