Botox’s Possible Benefits

Doctors are studying how botulinum toxin, or Botox, can be used to help prevent scarring when injected within a couple of weeks of surgery. Existing scars won’t benefit from this treatment, but if a large scar is surgically reduced, Botox might be able to help prevent scarring at the new incision site.

Botulinum toxin weakens muscles temporarily, reducing the pull on the scar during healing. “Botox ended up making the scars look better at the end of healing,” says researcher and facial plastic surgeon David Sherris, MD, a professor of otolaryngology at the University at Buffalo. “It’s really the first few months of the pull on the scar while it’s healing that causes the widening or sometimes thickening or depression of a scar.”

Sherris and his colleagues studied wounds on the face, comparing injections of Botox versus plain saline, and found that forehead wounds treated with one injection of Botox at the time of surgery healed with less scarring. They published the findings last year in the journal Mayo Clinic Proceedings. More recent work, to appear in Archives of Facial Plastic Surgery, showed that the improvement was the same for incisions in the lower face. The scientists hope to launch a full-scale trial to gain Food and Drug Administration approval for this use of the toxin.

Sherris says he doesn’t see any reason why Botox wouldn’t work elsewhere, in areas such as the sternum that are especially prone to scarring. Since Botox is FDA-approved for other cosmetic purposes, doctors can already use it “off-label” for this, although insurance probably won’t pay for the injection. It costs $200 or more, depending on the size of the incision. An injection anytime within two weeks of the surgery will help, Sherris says.

The effects of the botulinum toxin on muscles wear off after a few months, but by then it isn’t needed anymore, he says.