Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Botulinum toxin helps facial scars heal better

10.08.2006
Mayo Clinic researchers have found that treating a facial wound in the early healing phase with botulinum toxin (BOTOX®) improves the appearance of a scar later. The findings are published in the August issue of Mayo Clinic Proceedings.

"Our findings show that botulinum toxin offers an additional tool in preventing the formation of bad scars," says Holger Gassner, M.D., lead study researcher and former Mayo Clinic ear, nose and throat surgical resident who is now a fellow in Facial Plastic Surgery at the University of Washington in Seattle. "It will give us the option to optimize healing of forehead wounds in the first place and possibly allow us to avoid later surgeries to improve the scar's appearance."

Adds David Sherris, M.D., study investigator and former Mayo Clinic ear, nose and throat specialist who is now professor and chair of Otolaryngology at the University of New York at Buffalo, "This is the first medication found to minimize scarring. This is of substantial interest in the field of scar treatment. When a wound occurs, especially on the face, people are always worried about the scar. We can now try and improve scars with these injections."

The researchers found that an injection with botulinum toxin early after the occurrence of a wound -- such as trauma from a dog bite, motor vehicle accident or assault, or from a skin cancer biopsy or removal -- paralyzes the region, creating a smooth surface in which the wound can heal. This prevents muscle movement from wrinkling the wound site, allowing for a flat surface for healing and leaving a smoother final scar. The same process also could work if an unsightly older scar is surgically removed, and then botulinum toxin is injected into the wound at the time of the scar revision surgery, according to Dr. Gassner. "That's why our results with the botulinum toxin are so promising," says Dr. Gassner. "We can now for the first time eliminate the muscles' effect on healing for the first two to three months after the wound occurs."

Facial scarring can have a pronounced effect on patients' quality of life, according to Dr. Gassner.

"In general, we know that scars can cause functional problems -- they can interfere with eye closure, talking and eating," he says. "They also can have a deep psychological impact. For patients who have accidents that produce significant scarring, their lives can be profoundly changed. They can become depressed and withdraw socially."

Muscles may repeatedly distort wounds in the healing phase, which can result in inflammation that produces a thicker or wider scar. This is especially a problem with scars that cross muscle motion in the face, rather than lying parallel to muscle motion, a scenario common in cuts from dog bites or car accidents, says Anthony Brissett, M.D., study co-investigator and former clinician investigator at Mayo Clinic who is now director of Facial Plastic and Reconstructive Surgery at Baylor College of Medicine in Houston.

Scar reduction techniques designed to reduce the effects of muscle tension on a wound and to improve the final appearance of the scar include special stitches that pull the wound together and local flaps that bring additional skin into the wound bed. Injections of botulinum toxin in a wound differ in that they deter the muscle tension in the first place, says Clark Otley, M.D., study co-investigator and chair of the Division of Dermatologic Surgery at Mayo Clinic.

Side effects were minimal with the botulinum toxin injections, according to Dr. Sherris, including an occasional small bruise at the injection site or a headache. The largest potential risk in injecting this substance in the facial area would be transient paralysis of an important function. For example, he says a physician would not want to inject the eyelid, as this would impede its eye protection role. Patients in the trial also experienced positive side effects, such as a "good wrinkle benefit," according to Dr. Sherris, as the amount used to treat scarring is similar to that used to treat wrinkles.

The researchers undertook this trial after seeing significant results in wound healing with botulinum toxin in a basic research study. In the human trial, the researchers recruited patients with forehead wounds from trauma such as auto accidents, or from surgery, such as skin cancer excision. Forehead wounds were selected for study as they are a frequent site of facial scarring. Patients were randomly selected to receive injections with botulinum toxin or with saline, a benign substance used for comparison. All 31 patients' wounds were photographed at the time of the initial treatment and injection and again six months after initial treatment. Two experienced facial plastic surgeons rated the wounds' appearance on a scale in which 0 was the worst appearance and 10 was the best. These assessors were not informed about which patients received which treatment. The researchers averaged the ratings of the two surgeons for a final scar appearance score for each patient's wound. They found that the facial plastic surgeons rated the cosmetic results of the wounds injected with botulinum toxin more favorably than the wounds injected with saline. Median scores for wounds injected with botulinum toxin were 8.9, versus a median score of 7.1 for those injected with saline, a significant difference in appearance, according to the researchers.

Although injections with botulinum toxin would be available at local physicians' offices throughout the country, the injections are not yet approved for this use by the Food and Drug Administration (FDA).

The next step in this research, according to Dr. Sherris, would be to conduct a Phase III, multicenter trial with hundreds of patients to determine the appropriate dosage of the botulinum toxin; discover whether the injections are useful for better healing of scars elsewhere on the body, such as heart surgery wounds; and to provide more findings to present to the FDA to seek approval for this treatment.

John Murphy | EurekAlert!
Further information:
http://www.mayo.edu
http://www.mayoclinic.com

More articles from Health and Medicine:

nachricht Team discovers how bacteria exploit a chink in the body's armor
20.01.2017 | University of Illinois at Urbana-Champaign

nachricht Rabies viruses reveal wiring in transparent brains
19.01.2017 | Rheinische Friedrich-Wilhelms-Universität Bonn

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Traffic jam in empty space

New success for Konstanz physicists in studying the quantum vacuum

An important step towards a completely new experimental access to quantum physics has been made at University of Konstanz. The team of scientists headed by...

Im Focus: How gut bacteria can make us ill

HZI researchers decipher infection mechanisms of Yersinia and immune responses of the host

Yersiniae cause severe intestinal infections. Studies using Yersinia pseudotuberculosis as a model organism aim to elucidate the infection mechanisms of these...

Im Focus: Interfacial Superconductivity: Magnetic and superconducting order revealed simultaneously

Researchers from the University of Hamburg in Germany, in collaboration with colleagues from the University of Aarhus in Denmark, have synthesized a new superconducting material by growing a few layers of an antiferromagnetic transition-metal chalcogenide on a bismuth-based topological insulator, both being non-superconducting materials.

While superconductivity and magnetism are generally believed to be mutually exclusive, surprisingly, in this new material, superconducting correlations...

Im Focus: Studying fundamental particles in materials

Laser-driving of semimetals allows creating novel quasiparticle states within condensed matter systems and switching between different states on ultrafast time scales

Studying properties of fundamental particles in condensed matter systems is a promising approach to quantum field theory. Quasiparticles offer the opportunity...

Im Focus: Designing Architecture with Solar Building Envelopes

Among the general public, solar thermal energy is currently associated with dark blue, rectangular collectors on building roofs. Technologies are needed for aesthetically high quality architecture which offer the architect more room for manoeuvre when it comes to low- and plus-energy buildings. With the “ArKol” project, researchers at Fraunhofer ISE together with partners are currently developing two façade collectors for solar thermal energy generation, which permit a high degree of design flexibility: a strip collector for opaque façade sections and a solar thermal blind for transparent sections. The current state of the two developments will be presented at the BAU 2017 trade fair.

As part of the “ArKol – development of architecturally highly integrated façade collectors with heat pipes” project, Fraunhofer ISE together with its partners...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Sustainable Water use in Agriculture in Eastern Europe and Central Asia

19.01.2017 | Event News

12V, 48V, high-voltage – trends in E/E automotive architecture

10.01.2017 | Event News

2nd Conference on Non-Textual Information on 10 and 11 May 2017 in Hannover

09.01.2017 | Event News

 
Latest News

Helmholtz International Fellow Award for Sarah Amalia Teichmann

20.01.2017 | Awards Funding

An innovative high-performance material: biofibers made from green lacewing silk

20.01.2017 | Materials Sciences

Ion treatments for cardiac arrhythmia — Non-invasive alternative to catheter-based surgery

20.01.2017 | Life Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>