Add-on benefits of botulinum toxin type A in combination or sequential therapies for scar management: a systematic review and meta-analysis - Report - MDSpire

Add-on benefits of botulinum toxin type A in combination or sequential therapies for scar management: a systematic review and meta-analysis

  • By

  • Yunfei Ma

  • Wanming Qu

  • June 11, 2026

  • 0 min

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Clinical Report: Evaluating the Additional Advantages of Botulinum Toxin Type A in Combination or Sequential Treatment Approaches for Scar Management

Overview

This systematic review and meta-analysis evaluates the efficacy of botulinum toxin type A (BoNT-A) as an adjunctive treatment in scar management. The findings suggest that BoNT-A may significantly improve scar appearance, although the evidence is of low certainty.

Background

Scarring is a common consequence of wound healing that can lead to functional impairment and psychological distress. Various treatment modalities exist, but outcomes are often variable, prompting the use of multimodal strategies. BoNT-A has emerged as a potential adjunctive therapy aimed at reducing mechanical tension on healing wounds, which is a key factor in pathological scar formation.

Data Highlights

Outcome MeasureMean Difference (MD)
Vancouver Scar Scale (VSS)-1.80
Stony Brook Scar Evaluation Scale (SBSES)1.46

Key Findings

  • BoNT-A significantly improved scar appearance with a MD of -1.80 for VSS.
  • BoNT-A showed a MD of 1.46 for SBSES, indicating improved scar evaluation.
  • The evidence supporting BoNT-A's efficacy is classified as low-certainty.
  • Mechanical tension is a recognized contributor to pathological scar formation.
  • BoNT-A may facilitate more favorable scar maturation by reducing local muscle activity.

Clinical Implications

Clinicians should consider the potential adjunctive benefits of BoNT-A in scar management, particularly in cases where mechanical tension is a concern. However, treatment plans should remain individualized and cautious due to the low-certainty evidence.

Conclusion

While BoNT-A may offer benefits in scar management, further high-quality, standardized randomized controlled trials are necessary to confirm these findings.

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  8. Management of Keloids and Hypertrophic Scars | AAFP
  9. Effectiveness of Botulinum Toxin-A on Face, Head, and Neck Scars: A Systematic Review and Meta-Analysis - Almoaidbellah Rammal, Ahmed Mogharbel, 2024
  10. Efficacy of triamcinolone acetonide combined with botulinum toxin A in the treatment of hypertrophic scars and keloids: A meta-analysis - ScienceDirect

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