Efficacy of Botulinum Toxin A in Preventing Recurrence Keloids: Double Blinded Randomized Controlled Trial Study: Intraindividual Subject
Chatchai Pruksapong MD, FRCST*, Sanipreeya Yingtaweesittikul MD, FRCST*, Chairat Burusapat MD, FRCST*
Affiliation : * Division of Plastic and Reconstructive Surgery, Department of Surgery, Phramongkutklao Hospital and College of Medicine, Bangkok, Thailand
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.
Keywords : Keloid, Botulinum toxin A, Corticotherapy
