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Clague MD, Goodman G, Taing C, Stuart L, Orsatti ML, Holbrook J, Delaney J, Mackay B. Hyperdiluted Botulinum Toxin and Intense Pulsed Light Treatment: A Case Series to Illustrate a Novel Protocol for Hypertrophic Scar Reduction. Plast Aesthet Nurs (Phila) 2024; 44:116-123. [PMID: 38639968 DOI: 10.1097/psn.0000000000000551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/20/2024]
Abstract
Hypertrophic scars can have significant and far-reaching effects on patients that range from itching to creating difficulty with mobility, all of which can negatively impact the individual's quality of life. A recent study showed that many patients with recent scars report pain, burning, pruritus, erythema, in combination with psychological difficulties that impact bodily movement, choice of clothing, and participation in leisure activities. Botulinum toxin Type A (BoNTA) and intense pulsed light (IPL) have shown promise in treating such scars. We propose a novel treatment protocol involving a 4-week intervention with hyperdiluted BoNTA injections and supplemental treatment with IPL for erythema, and a 6-month scar scale assessment and photographic documentation that occurs before and 6 months after treatment. We report four cases where using hyperdiluted BoNTA, either alone or in conjunction with IPL, substantially reduced scar size, improved overall scar appearance, and diminished erythema in areas on the face and the breasts. Although this report suggests that a schedule of alternating treatments with BoNTA and IPL may be beneficial in reducing scar size and enhancing appearance, further research is necessary to better understand the most effective dosages, the relationship between BoNTA and IPL, and the optimal management of scarring.
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Affiliation(s)
- Mike D Clague
- Mike D. Clague, BSc , is at Facecoach, South Yarra, Victoria, Australia
- Greg Goodman, MD, MBBS, FACD , is at Facecoach, South Yarra, Victoria, Australia
- Cindy Taing, BSN , is at Facelove, St Kilda, Victoria, Australia
- Lauren Stuart, BSN , is at Facelove, St Kilda, Victoria, Australia
- Margo-Louise Orsatti, BSN , is at Facelove, St Kilda, Victoria, Australia
- John Holbrook, MBBS , is Founder, Fresh Clinics, Lavender Bay, New South Wales, Australia
- John Delaney, MBBS (Hons1) , is Founder Fresh Clinics, Lavender Bay, New South Wales, Australia
- Bridgina Mackay, MN, GradCert ICU , is Lecturer at Australian Catholic University, Melbourne, Victoria, Australia
| | - Greg Goodman
- Mike D. Clague, BSc , is at Facecoach, South Yarra, Victoria, Australia
- Greg Goodman, MD, MBBS, FACD , is at Facecoach, South Yarra, Victoria, Australia
- Cindy Taing, BSN , is at Facelove, St Kilda, Victoria, Australia
- Lauren Stuart, BSN , is at Facelove, St Kilda, Victoria, Australia
- Margo-Louise Orsatti, BSN , is at Facelove, St Kilda, Victoria, Australia
- John Holbrook, MBBS , is Founder, Fresh Clinics, Lavender Bay, New South Wales, Australia
- John Delaney, MBBS (Hons1) , is Founder Fresh Clinics, Lavender Bay, New South Wales, Australia
- Bridgina Mackay, MN, GradCert ICU , is Lecturer at Australian Catholic University, Melbourne, Victoria, Australia
| | - Cindy Taing
- Mike D. Clague, BSc , is at Facecoach, South Yarra, Victoria, Australia
- Greg Goodman, MD, MBBS, FACD , is at Facecoach, South Yarra, Victoria, Australia
- Cindy Taing, BSN , is at Facelove, St Kilda, Victoria, Australia
- Lauren Stuart, BSN , is at Facelove, St Kilda, Victoria, Australia
- Margo-Louise Orsatti, BSN , is at Facelove, St Kilda, Victoria, Australia
- John Holbrook, MBBS , is Founder, Fresh Clinics, Lavender Bay, New South Wales, Australia
- John Delaney, MBBS (Hons1) , is Founder Fresh Clinics, Lavender Bay, New South Wales, Australia
- Bridgina Mackay, MN, GradCert ICU , is Lecturer at Australian Catholic University, Melbourne, Victoria, Australia
| | - Lauren Stuart
- Mike D. Clague, BSc , is at Facecoach, South Yarra, Victoria, Australia
- Greg Goodman, MD, MBBS, FACD , is at Facecoach, South Yarra, Victoria, Australia
- Cindy Taing, BSN , is at Facelove, St Kilda, Victoria, Australia
- Lauren Stuart, BSN , is at Facelove, St Kilda, Victoria, Australia
- Margo-Louise Orsatti, BSN , is at Facelove, St Kilda, Victoria, Australia
- John Holbrook, MBBS , is Founder, Fresh Clinics, Lavender Bay, New South Wales, Australia
- John Delaney, MBBS (Hons1) , is Founder Fresh Clinics, Lavender Bay, New South Wales, Australia
- Bridgina Mackay, MN, GradCert ICU , is Lecturer at Australian Catholic University, Melbourne, Victoria, Australia
| | - Margo-Louise Orsatti
- Mike D. Clague, BSc , is at Facecoach, South Yarra, Victoria, Australia
- Greg Goodman, MD, MBBS, FACD , is at Facecoach, South Yarra, Victoria, Australia
- Cindy Taing, BSN , is at Facelove, St Kilda, Victoria, Australia
- Lauren Stuart, BSN , is at Facelove, St Kilda, Victoria, Australia
- Margo-Louise Orsatti, BSN , is at Facelove, St Kilda, Victoria, Australia
- John Holbrook, MBBS , is Founder, Fresh Clinics, Lavender Bay, New South Wales, Australia
- John Delaney, MBBS (Hons1) , is Founder Fresh Clinics, Lavender Bay, New South Wales, Australia
- Bridgina Mackay, MN, GradCert ICU , is Lecturer at Australian Catholic University, Melbourne, Victoria, Australia
| | - John Holbrook
- Mike D. Clague, BSc , is at Facecoach, South Yarra, Victoria, Australia
- Greg Goodman, MD, MBBS, FACD , is at Facecoach, South Yarra, Victoria, Australia
- Cindy Taing, BSN , is at Facelove, St Kilda, Victoria, Australia
- Lauren Stuart, BSN , is at Facelove, St Kilda, Victoria, Australia
- Margo-Louise Orsatti, BSN , is at Facelove, St Kilda, Victoria, Australia
- John Holbrook, MBBS , is Founder, Fresh Clinics, Lavender Bay, New South Wales, Australia
- John Delaney, MBBS (Hons1) , is Founder Fresh Clinics, Lavender Bay, New South Wales, Australia
- Bridgina Mackay, MN, GradCert ICU , is Lecturer at Australian Catholic University, Melbourne, Victoria, Australia
| | - John Delaney
- Mike D. Clague, BSc , is at Facecoach, South Yarra, Victoria, Australia
- Greg Goodman, MD, MBBS, FACD , is at Facecoach, South Yarra, Victoria, Australia
- Cindy Taing, BSN , is at Facelove, St Kilda, Victoria, Australia
- Lauren Stuart, BSN , is at Facelove, St Kilda, Victoria, Australia
- Margo-Louise Orsatti, BSN , is at Facelove, St Kilda, Victoria, Australia
- John Holbrook, MBBS , is Founder, Fresh Clinics, Lavender Bay, New South Wales, Australia
- John Delaney, MBBS (Hons1) , is Founder Fresh Clinics, Lavender Bay, New South Wales, Australia
- Bridgina Mackay, MN, GradCert ICU , is Lecturer at Australian Catholic University, Melbourne, Victoria, Australia
| | - Bridgina Mackay
- Mike D. Clague, BSc , is at Facecoach, South Yarra, Victoria, Australia
- Greg Goodman, MD, MBBS, FACD , is at Facecoach, South Yarra, Victoria, Australia
- Cindy Taing, BSN , is at Facelove, St Kilda, Victoria, Australia
- Lauren Stuart, BSN , is at Facelove, St Kilda, Victoria, Australia
- Margo-Louise Orsatti, BSN , is at Facelove, St Kilda, Victoria, Australia
- John Holbrook, MBBS , is Founder, Fresh Clinics, Lavender Bay, New South Wales, Australia
- John Delaney, MBBS (Hons1) , is Founder Fresh Clinics, Lavender Bay, New South Wales, Australia
- Bridgina Mackay, MN, GradCert ICU , is Lecturer at Australian Catholic University, Melbourne, Victoria, Australia
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