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The Efficacy of Laser and Botox Therapies for Post-Thyroidectomy Scar Management: A Comprehensive Systematic Review
Maan Magboul1, Abdulsalam Alqutub2, Hamza Fadel3
1Department of Dermatology, King Abdulaziz Medical City-National Guard, Riyadh, Saudi Arabia. maanmaqboul@gmail.com.
Background:
Post-thyroidectomy scars remain a major concern that adversely impacts the patient's quality of life despite surgical advancements. Recently interventions such as laser and Botulinum toxin type A (Botox) have emerged to enhance the cosmetic outcome of these operations.
Objective:
To evaluate the effectiveness of laser and Botox in treating post-thyroidectomy scars.
Methods:
We conducted searches through various databases involving PubMed, Scopus, Web of Science, and Cochrane Library from inception until February 2025. Studies evaluating the effectiveness of laser or Botox for managing post-thyroidectomy scars were included. Our study outcomes were the modified Stony Brook Scar Evaluation Scale (mSBSES), Vancouver Scar Scale (VSS), Patient Scar Assessment Scale (PSAS), and Observer Scar Assessment Scale (OSAS). Continuous data were pooled as mean difference (MD) with 95% confidence interval (CI).
Results:
In total, 24 studies encompassing 919 patients were included. Our pooled effect estimate revealed higher mSBSES scores in patients treated with Botox compared to placebo (MD = 1.69, 95% CI [0.17 to 3.22], P = 0.03). Additionally, the laser plus steroid therapy showed a significant reduction in PSAS score (MD = -10.77, 95% CI [-14.03 to -7.51], P = 0.001) and OSAS score (MD = -6.11, 95% CI [-9.63 to -2.60], P = 0.001) compared to control group.
Conclusion:
Botox and laser therapy showed promising results in improving the cosmetic outcomes of post-thyroidectomy scars. Due to the significant heterogeneity in the intervention protocols, assessment durations, and different scar assessment tools, further studies with standardized intervention protocols and assessment methods are required.
Level Of Evidence I:
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
