Can Botox Help Smooth Scars Out?

I recently had foot surgery and am developing a bad scar.

Doctor Answers 9

Botox and scars

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Let me first point out that the FDA has approved Botox for specific indications. When it is used in this capacity, it is called an "off-label" use.

As Dr. Sinclair points out, if scars are aggravated or made worse by muscle action, then it would make sense that weakening the underlying muscles may improve the scar. This has been shown to be true in certain situations.

Recently there has been some evidence that very large scars (hypertrophic) or keloid scars may also benefit according to some anecdotal reports.

  • Traditionally these scars have been treated with topical silicone, pressure, injected steroids, surgery and radiation therapy in order of increasing severity.
  • However, there are some recent reports that the use botox and even 5 FU ( a chemotherapy agent) may also prove useful in some cases of severe scarring.

Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Botox To Help Smooth Scars Out

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Botox has been documented to help with scar removal but the treatment is off label and risky. It is not a procedure that we perform. Other options include lasers, injections, silicone sheets, and surgery.

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon
4.5 out of 5 stars 56 reviews

Foot surgery scar should be evaluated for functional problems before cosmetic.

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Before you investigate Botox for scar improvement (probably not appropriate in this situation), it would be best to return to the surgeon who operated on your foot to make sure the physical foot function is good and healthy, and that the scar is only a cosmetic issue. Then ask the surgeon what can be done to improve the scar. Keep in mind that scars take 6 months to 2 years to achieve a final look, and really continue to improve every single day after that.

Jessica J. Krant, MD, MPH
New York Dermatologic Surgeon
4.7 out of 5 stars 41 reviews

Botox and Scars

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Botox does improve scars but the issue is the timing of when Botox is injected.  It should be injected either just before or at the time of closure to allow the tissues to heal better by preventing micro movements of the surrounding tissues.  An analogy can be seen in a fracture which is cast in place to prevent the bone fragments to stay in position so that healing can occur.  It is thought that Botox prevents the local tissue from moving as much, allowing it more of an opportunity to heal better.

Attached is a clip of me on RTL (German National TV) on this topic.  Sorry it is German but the translation link is attached.

Anil R. Shah, MD
Chicago Facial Plastic Surgeon
4.8 out of 5 stars 181 reviews

Scarring and Botox

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Typically Botox is used to reduce or eliminate the appearance of facial wrinkles. Botox is not indicated for treatment of scars. There are better alternatives for the treatment of scars. Discuss with your dermatologist or plastic surgeon what the best treatment options there are for your scar.

Sanusi Umar, MD
Redondo Beach Dermatologic Surgeon
4.6 out of 5 stars 33 reviews

Yes, Botox can help with scar revision

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If a scar is unfavorable (meaning that the intrinsic forces of the tissues tends to seperate the scar) there is good evidence that Botox will help the final results of scar revision.  This is an "off label" use.  Insurance would likely not cover Botox for this reason.  It is a reasonable option to try if you are undergoing scar revision.

Gregory Pippin, MD
Metairie Facial Plastic Surgeon

Botox may be used for scars, but it's off label

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There are reports that Botox may help some scars, but this use is experimental. I would try everything else that is evidence supported, before jumping to Botox. 

John P. Di Saia, MD
Orange Plastic Surgeon

Improving bad scars and hypertrophic scars

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Bad scars have multiple causes and it is not as simple as injecting Botox.  If you came to my office, I would perform a full examination and determine the source of your scars.  At that point, there are options with lasers, injections, silicone sheets, and surgery.

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
4.8 out of 5 stars 95 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.