The response of burn scars to intralesional verapamil. Report of five cases

Postburn dermal scars can be aesthetically disfiguring and severely disabling. Existing medical and surgical strategies to prevent or to treat scars are all too often disappointing. More effective strategies are needed. It has been postulated that cell membrane calcium channel blockers could potentially trigger extracellular matrix degradation in dermal scars, resulting in scar volume reduction. To test this hypothesis, we studied the effects of intralesional verapamil hydrochloride therapy, 0.1 to 0.5 mmol/L, on scar volume and color in patients with burns. Our study chronicles five reports on arbitrarily selected clinical cases of hypertrophic burn scarring and the effect of therapy with intralesional verapamil. The cellular functions and processes explaining this effect are discussed. There were no significant side effects or complications from the verapamil therapy. It is now clear that regulation of fibroblast calcium metabolism is a safe and often effective strategy to treat hypertrophic scars. To our knowledge, this is the first clinical report of control of burn scar with calcium channel blockers.