AIM:To study the efficacy and safety of botulinum toxin type A in inhibiting scar formation of epicanthus.

METHODS: Patients with epicanthus received by our plastic department from March 2012 to March 2014 were chosen and randomly divided into two groups: Treatment group, 39 patients injected botulinum toxin immediately after surgery; Control group, 42 patients received correction of epicanthus without injection of botulinum toxin. Two experienced plastic surgeons evaluate the scar of patients in each group 6mo after the surgery by using internationally recommended OSAS scar evaluation questionnaire from color, smoothness, elasticity and scar width. The scar of two groups in 1 and 6mo after surgery were assessed respectively and statistical analysis was done.

RESULTS: Four patients in the treatment group and 6 patients in the control group were lost to follow-up, while the others were on regular follow-up and evaluation. The postoperative scar scoring in color, smoothness, elasticity and scar width had statistical significance compared to the control group in 1mo after surgery(P<0.05). Postoperative scar scoring in 6mo after surgery had no statistically significant difference in the color and elasticity(P>0.05), but in the smoothness and scar width(P<0.05). The most obvious scar occurs after 1mo, and had a statistically significant difference compared to 6mo after surgery(P<0.05). During the follow-up, no one complained wound pain and itching in treatment group, while 5 patients had a slight wound itch within 3mo after surgery in the control group; no complications occurred in two groups.

CONCLUSION: Botulinum toxin can not only reduce the short-term postoperative scar formation and inflammatory reaction itching and pain to a certain extent, but also achieve long-term flat appearance of incision and reduce the risk of scarring, which deserves an application in clinical practice.