Sutedja Eva Krishna, Sutedja Endang, Ruchiatan Kartika, Faldian Yogi, Ismiranty Dyah, Putri Ananda Dwi
Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran-Dr. Hasan Sadikin Hospital, Bandung, Indonesia.
Clin Cosmet Investig Dermatol. 2025 Sep 1;18:2103-2117. doi: 10.2147/CCID.S528974. eCollection 2025.
Keloids are fibroproliferative disorders characterized by excessive scarring, functional impairment, and aesthetic concerns. Despite the availability of various treatments, recurrence rates remain high, highlighting the need for alternative therapies with favorable safety profiles. Botulinum toxin A (BTX-A) has emerged as a potential option for keloid treatment; however, its therapeutic role is still not fully elucidated. The aim of this study was to evaluate the efficacy and safety of BTX-A in the treatment of keloids through a structured review of available literature.
This literature review was conducted from three scientific databases: PubMed, Scopus, and Cochrane. The following keywords used were "botulinum toxin", "BTX-A", "botulinum toxin A", and "keloids". Original studies published in English between 2014 and 2024 that involved human subjects and investigated the use of BTX-A in the treatment of keloids were included.
A total of eleven randomized controlled trials were included in this review. Of these, eight studies reported statistically significant improvements in keloid characteristics such as height, pliability, and vascularity following intralesional BTX-A treatment, as measured by validated scales like the Vancouver Scar Scale (VSS). Two studies demonstrated comparable efficacy between BTX-A and intralesional triamcinolone acetonide (TAC). Adverse events were rare and generally limited to mild local reactions. In addition, BTX-A has been shown to be safe for use as a keloid therapy even in the pediatric population.
BTX-A showed satisfactory efficacy and safety. In addition, BTX-A showed significant improvement in subjective symptoms in keloid lesions, making BTX-A a promising alternative option for keloid therapy.
瘢痕疙瘩是一种纤维增生性疾病，其特征为过度瘢痕形成、功能障碍和美观问题。尽管有多种治疗方法，但复发率仍然很高，这凸显了对具有良好安全性的替代疗法的需求。肉毒杆菌毒素A（BTX-A）已成为瘢痕疙瘩治疗的一种潜在选择；然而，其治疗作用仍未完全阐明。本研究的目的是通过对现有文献的结构化综述来评估BTX-A治疗瘢痕疙瘩的疗效和安全性。
本综述从三个科学数据库进行：PubMed、Scopus和Cochrane。使用的关键词如下：“肉毒杆菌毒素”、“BTX-A”、“肉毒杆菌毒素A”和“瘢痕疙瘩”。纳入2014年至2024年期间发表的涉及人类受试者并研究BTX-A治疗瘢痕疙瘩的原始英文研究。
本综述共纳入11项随机对照试验。其中，八项研究报告称，通过温哥华瘢痕量表（VSS）等经过验证的量表测量，病灶内注射BTX-A治疗后，瘢痕疙瘩的特征如高度、柔韧性和血管分布有统计学上的显著改善。两项研究表明BTX-A与病灶内注射曲安奈德（TAC）疗效相当。不良事件罕见，一般仅限于轻度局部反应。此外，即使在儿科人群中，BTX-A也已被证明作为瘢痕疙瘩治疗是安全的。
BTX-A显示出令人满意的疗效和安全性。此外，BTX-A在瘢痕疙瘩病灶的主观症状方面有显著改善，使BTX-A成为瘢痕疙瘩治疗的一种有前景的替代选择。
