The Cellular Response of Keloids and Hypertrophic Scars to Botulinum Toxin A: A Comprehensive Literature Review

Austin, Evan; Koo, Eugene; Jagdeo, Jared

doi:10.1097/dss.0000000000001360

Cited by 40 publications

(49 citation statements)

References 48 publications

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“…Another theory of mechanism of BoNT‐A on hypertrophic scars and keloids is the effect on cell cycle distribution of fibroblasts. Fibroblasts hyperproliferation is one of the factors that result in hypertrophic scars and keloids . BoNT‐A may directly modulate the activity of fibroblast by altering apoptotic, migratory, and fibrotic pathways on pathological scars and thus improve their appearance .…”

Section: Mechanism Of Action Of Botulinum Toxin Type a On Hypertrophimentioning

confidence: 99%

“…Fibroblasts hyperproliferation is one of the factors that result in hypertrophic scars and keloids. 20 BoNT-A may directly modulate the activity of fibroblast by altering apoptotic, migratory, and fibrotic pathways on pathological scars and thus improve their appearance. 20 Another experiment by Zhibo et al showed BoNT-A does act on fibroblasts directly, but the experiment did not explain how.…”

Section: Bont-a Action On Cell Cycle and Gene Expression Of Fibroblmentioning

confidence: 99%

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Botulinum toxin type A for the treatment and prevention of hypertrophic scars and keloids: Updated review

Carrero

Liu

et al. 2018

J of Cosmetic Dermatology

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Botulinum Toxin Type A is a potent neurotoxin that is produced by a gram‐positive bacteria clostridium botulinum. Its utilization in the treatment of various medical condition has expanded over the years in both medical and esthetic uses. It is being preferred by most physicians due to its efficacy and lack of side effects. It can be used as monotherapy or combined therapy. The aim of this review study was to show the role and mechanism of action of Botulinum toxin type A in the treatment and prevention of hypertrophic scars and keloids. The clear mechanisms underlying hypertrophic scars and keloids are still not clearly understood; however, the mechanism of action of Botulinum toxin type A has been shown to include action on wound tension, action on collagen, and action on fibroblasts. Different randomized controlled trials, double‐blind, and placebo‐controlled studies have been conducted to investigate its use in treatment and prevention of hypertrophic scars and keloids, and it still is one of the active areas of research in Dermatology and related fields. Method: In March 2018, we performed a literature search in PubMed for clinical studies, clinical trials, case reports, controlled trials, randomized controlled trials, and systemic reviews. The search terms we used were “BOTULINUM TOXIN” AND “HYPERTROPHIC SCARS” OR “KELOIDS” (from 1980). The search resulted in 1000 articles, out of these 35 articles met our inclusion exclusion criteria. Our inclusion criteria included relevant original articles relevant, critical systemic reviews, and crucial referenced articles, exclusion criteria included duplicates and articles not published in English language. We have reviewed these papers to show the role and mechanism of action of Botulinum toxin type A in the treatment and prevention of hypertrophic scars and keloids.

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Section: Mechanism Of Action Of Botulinum Toxin Type a On Hypertrophimentioning

confidence: 99%

Section: Bont-a Action On Cell Cycle and Gene Expression Of Fibroblmentioning

confidence: 99%

Botulinum toxin type A for the treatment and prevention of hypertrophic scars and keloids: Updated review

Carrero

Liu

et al. 2018

J of Cosmetic Dermatology

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“…However, the N‐terminal of BTXA light chain has the activity of zinc metalloproteinase, which can cut the synaptosomal‐associated protein of 25 kDa (SNAP‐25) and prevent the release of acetylcholine into the synaptic cleft, thus causing “chemo‐denervation,” reducing the tension on both sides of the wound and affecting the scar morphology . In addition, some evidences suggest that BTXA may affect scar formation by reducing fibroblast proliferation, reducing TGF‐β expression, and altering collagen deposition and remodeling processes . Two experiments by Xiao, Z. et al indicated that BTXA can effectively inhibit the proliferation of fibroblasts derived from hypertrophic scar and further reduce the content of TGF‐β1 and its downstream regulator connective tissue growth factor (CTGF) .…”

Section: Discussionmentioning

confidence: 99%

“…25,26 In addition, some evidences suggest that BTXA may affect scar formation by reducing fibroblast proliferation, reducing TGF-β expression, and altering collagen deposition and remodeling processes. 27 further reduce the content of TGF-β1 28 and its downstream regulator connective tissue growth factor (CTGF). 29 Jeong et al 30 Two meta-analysis results published by Wang 32 and Wang 33 before including 9 studies respectively have showed that BTXA injection is a safe and effective treatment for scar prevention, but some recent studies have reached negative conclusions.…”

Section: Adverse Eventsmentioning

confidence: 99%

The Safety and efficacy of botulinum toxin type A injection for postoperative scar prevention: A systematic review and meta‐analysis

Yang

2019

J of Cosmetic Dermatology

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Background Active prevention and treatment of scars are particularly important. Several studies have used botulinum toxin type A(BTXA) to prevent postoperative scarring. The aim of this systematic review and meta‐analysis was to systematically evaluate the efficacy and safety of BTXA in preventing and treating postoperative scars. Methods A computer‐based search was conducted for the five databases including PubMed, Cochrane Library, EMBASE, CNKI, and Wanfang up to May 22, 2019, to collect the relevant literatures on BTXA treatment of postoperative hypertrophic scars. A meta‐analysis was made with the software of Revman 5.3 based on the study endpoint of scar width, Vancouver Scar Scale (VSS), Visual Analogue Scale (VAS) scores, and patient satisfaction as well. Results A total of 18 randomized controlled trials (RCTs) studies were included with 915 patients in all. The result showed that, compared with the control group, the scar width, VAS scores, and VSS scores of the BTXA group were significantly improved and higher patient satisfaction was achieved. Conclusion BTXA has a certain curative effect on postoperative scar prevention and treatment without obvious side effects.

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“…Keloids mostly affect, but are not limited to, younger patients with higher Fitzpatrick skin phototypes [5]. Keloid scars tend to develop more readily during and after puberty, and disproportionately affect African American, Latin American, and Asian populations with a prevalence ranging from 0.3 to 16% [6].…”

Section: Introductionmentioning

confidence: 99%

Keloid Formation due to Repetitive Mammographies

Pruimboom

Scheltinga

2018

Case Rep Dermatol

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The Cellular Response of Keloids and Hypertrophic Scars to Botulinum Toxin A: A Comprehensive Literature Review

Cited by 40 publications

References 48 publications

Botulinum toxin type A for the treatment and prevention of hypertrophic scars and keloids: Updated review

Botulinum toxin type A for the treatment and prevention of hypertrophic scars and keloids: Updated review

The Safety and efficacy of botulinum toxin type A injection for postoperative scar prevention: A systematic review and meta‐analysis

Keloid Formation due to Repetitive Mammographies

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