Intralesional Botulinum Toxin A for Keloid Treatment: A Review of Efficacy, Safety, and Clinical Applications.

[BACKGROUND] 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.

[METHODS] 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.

[RESULTS] 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.

[CONCLUSION] 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.