Injecting botulinum toxin (familiarly known as Botox) into muscles surrounding forehead wounds improves the appearance of the scar when it has healed. Immobilizing the muscles with botulinum toxin promises to become a valuable additional adjunctive treatment for those physicians and patients who want to achieve the best possible cosmetic outcome. Researchers from the Mayo Clinic, in Rochester, Minnesota, USA, investigated whether botulinum toxin injections compared to inactive placebo injections affected the cosmetic appearance of healed forehead lacerations in 31 patients. The average rating for appearance on a scale ranging from 0 (worst possible outcome) to 10 (ideal outcome) after 6 months was 9 for the botulinum toxin-treated group and 7 for the placebo group, a significant improvement. Other than mild headaches in one placebo patient, there were no complications or adverse effects. Keeping the limitations of the current study in mind, it appeared reasonable to offer the treatment to patients who have sustained a forehead wound that had a high likelihood of noticeable scarring. The injections often cause mild and transient functional deficits, such as a drooping eyelid, but once patients understand this is a possibility they typically find it acceptable. The above treatment requires a physician well experienced in the injection of botulinum toxin in the face.
Mayo Clinic Proceedings,
August 2006