Efficacy of Botulinum Toxin A in Preventing Recurrence Keloids: Double Blinded Randomized Controlled Trial Study: Intraindividual Subject.

[BACKGROUND] Keloids have been one of the most concerning problems in cosmetic surgery. Current treatments still provide unpredictable outcomes. Interestingly, one molecular study of Botulinum Toxin A (BTXA) has found the inhibitive effect of fibroblast growth factor (TGF-β), which explain the mechanism of keloid formation.

[OBJECTIVE] To study the efficacy of BTXA in preventing keloids formation for clinical use.

[MATERIAL AND METHOD] Prospective randomized controlled trial study was conducted on 25 patients between March 2014 and June 2015. Fifty keloids from 25 patients were equally randomized into two groups, control and toxin group. After the scar excision, the control group was injected with corticotherapy, while the toxin group was injected with BTXA. The outcomes were assessed and evaluated using Vancouver Scar Scale (VSS) by two plastic surgeons. The VSS was compared between pre- and post-operative period. Follow-up protocols were made in both groups at 1-, 3-, and 6-month after surgery.

[RESULTS] According to the first and third-month follow-up, the outcome in toxin group was more favorable than the control group (6.22±1.72 vs. 5.89±1.83, p = 0.347), whereas the outcome in control group was more favorable than the toxin group in the sixth month follow-up (5.33±1.87 vs. 4.11±1.96, p = 0.010).

[CONCLUSION] BTXA is not significantly better in preventing recurrence keloids when compared to corticotherapy after one and three months. However, Corticotherapy provides a significantly better outcome than BTXA at 6-month follow-up.