High-dose BTxA safe, yields better scar appearance

High-dose injections of botulinum toxin type A (BTxA) immediately after surgery leads to a better appearance of the postoperative scar compared with low doses, a recent study has found.

Researchers enrolled 22 patients who had undergone surgery. BTxA injections were administered to either side of the wound; one half of the incision received a low dose (4 U), while the other was given a high dose (8 U). The outcome was scar appearance at postoperative month 6, as assessed by the modified Stony Brook Scar Evaluation Scale (mSBSES), as well as visual analogue scale (VAS)-quantified patient satisfaction.

Mean scores in the mSBSES were significantly greater in the high-dose side, suggesting better wound appearance at 6 months (5.90±1.59 vs 4.15±1.31; p<0.01).

Particularly, of the mSBSES subdomains, the high-dose BTxA injection produced significantly better outcomes in terms of width (1.65±0.49 vs 1.05±0.69; p<0.01) and incision visibility line (1.05±0.51 vs 0.50±0.61; p<0.01). No between-arm differences were reported for height and colour.

In turn, patient satisfaction was significantly higher for the high-dose vs low-dose side (mean VAS scores: 7.85±1.27 vs 5.20±1.40; p<0.01).

In terms of safety, there were no recorded serious adverse reactions or post-injection complications, such as muscle paralysis, allergies, botulism, infections, or haematoma.

“These findings indicate that early postoperative high-dose BTxA injections can provide better cosmetic effects than low-dose injections. Therefore, we recommend a high-dose BTxA injection immediately after the procedure to achieve a better scar beautification effect,” researchers said.