BOTULINUM TOXIN TYPE A FOR SCAR MODULATION: A SYSTEMATIC REVIEW AND TRANSLATIONAL PERSPECTIVES FOR GYNECOLOGY

Abstract

Tissue healing is a complex biological process, and its dysregulation may result in pathological scars associated with pain, functional impairment, and aesthetic changes. This study aimed to synthesize the evidence on the use of botulinum toxin type A (BTX-A) for scar modulation, considering its mechanisms of action, therapeutic effects, and potential application in regenerative gynecology. A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, with searches of electronic databases for studies published between 2020 and 2025 in Portuguese, English, or Spanish. Sixteen studies involving adult patients with different types of scars were included. The results indicated that BTX-A was associated with reduced scar tension, modulation of inflammatory responses, and improved collagen organization, with reported aesthetic and functional benefits. Favorable results were also observed compared with placebo and conventional treatments, as well as in combined approaches involving microneedling and CO₂ laser. In conclusion, BTX-A shows promising therapeutic potential for scar modulation, although higher-quality clinical studies are needed to establish treatment protocols, safety, and applicability in regenerative gynecology.