Botulinum toxin to improve facial wound healing: A prospective, blinded, placebo-controlled study

OBJECTIVE: To test whether botulinum toxin-induced immobilization of facial lacerations enhances wound healing and results in less noticeable scars. PATIENTS AND METHODS: In this blinded, prospective, randomized clinical trial, patients were randomized from February 1, 2002, until January 1, 2004, to botulinum toxin vs placebo injection into the musculature adjacent to the wound within 24 hours after wound closure. Blinded assessment of standardized photographs by experienced facial plastic surgeons using a 10-cm visual analog scale served as the main outcome measure. RESULTS: Thirty-one patients presenting with traumatic forehead lacerations or undergoing elective excisions of forehead masses were included in the study. The overall median visual analog scale score for the botulinum toxin-treated group was 8.9 compared with 7.2 for the placebo group (P=.003), indicating enhanced healing and improved cosmesis of the experimentally immobilized scars. CONCLUSIONS: Botulinum toxin-induced immobilization of forehead wounds enhances healing and is suggested for use in selected patients to improve the eventual appearance of the scar.