Background: Hyaluronic acid fillers have been studied extensively for facial wrinkles; however, their efficacy for atrophic facial scars has yet to be analyzed in a prospective placebo-controlled study.
Objective:To analyze the efficacy and safety of a hyaluronic acid filler for atrophic facial scars.Methods & Materials: Fifteen subjects were randomized to receive up to 1 ml of VYC-17.5 L on one cheek and up to 1 ml of saline on the other side, with an optional touch-up treatment. Subjects were graded by a live blind evaluator using the Quantitative Global Scarring Grading System (QGSGS) (J Cosmet Dermatol. 2006;5:48), the Global Aesthetic Improvement Scale (GAIS), and Canfield photo-analysis.Results: According to the blind evaluator, there was a significant reduction 90 days after the last treatment on the QGSGS for VYC-17.5L compared with saline (−6.6 VYC-17.5L vs −1.7 saline [t(28) = −4.3196, p = 0.008]). There was a smaller, but still significant reduction on the QGSGS for saline alone (10.4 to 8.6 [t(14) = −3.453, p = 0.004]). In addition, 93% (13/14) of subjects chose VYC-17.5L over saline treatment and reported an improvement on the GAIS. There were no serious side effects and all minor side effects resolved by Day 30.
Conclusion:VYC-17.5L achieved significant improvements in rolling atrophic scars as compared to saline, though saline also had modest improvements.
Although most clinicians agree that diffusion of Botulinum Neurotoxin (BoNT) occurs, its extent, timeline, and clinical importance has been debated. A literature search on PubMed (National Institutes of Health, Bethesda, MD) was done up to January 15, 2023, which included the following search terms: Botulinum Toxin A Uptake; Botulinum Toxin A Diffusion; and Botulinum Spread. A total of 421 publication titles were found and analyzed. Based on titles, the author selected 54 publications as potentially applicable and reviewed each one in depth along with their supporting references. There are several publications that support a novel theory in which small amounts of BoNT could remain in the area days after injection and spread to adjacent muscles. While current thinking is that BoNT is completely taken up within hours, making its spread days after injection of BoNT not a plausible theory, the following literature review and case report support a novel theory.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.