This past August a study published in the Mayo Clinic Proceedings found that Botox (trademarked name for Botulinum toxin type A), helped facial wounds heal with minimal scarring. The investigation involved 31 patients who had a facial wound. The patients received an injection of Botox or saline within 24 hours after the wound closed.

Two plastic surgeons not involved with the study reviewed and rated the healed scars on a scale of 1-10. The improvements with Botox scored 8.9 versus 7.1 for the saline treated scars.

David Sherris, MD, professor and chair of the Department of Otolaryngology at the University at Buffalo directed the study. Dr. Davis reports, "The reason this works is because wide scars are the result of the local muscles pulling the wound apart during the healing phase ...Botulinum toxin temporarily weakens the surrounding muscles, thereby lessening the pull on the wound during the acute healing phase of the first 2-4 months."

Based on these preliminary findings could Botox help with deep acne scarring? According to a report issued by Kiersten Coleman and Jean Carruthers in Dermatologic Therapy in May, Botox is best used in combination therapy where all of the elements of a skin imperfection can be corrected.

Several factors lend to the size and the depth of deep acne or pitted acne scars. This includes muscle strain and collagen loss that can result from inflammed acne cysts that expand beneath the skin and cause deep tissue damage.

Relaxing a tensed facial muscle with Botox can reduce the appearance of the depth of the scar. But because of collagen loss, the scar may still be evident. At this point a physician can inject cosmetic fillers made with collagen or hyaluronic acid to completely fill the acne scar and give it a look flush with the rest of the skin.

The only issue with treating depressed acne scars with combination therapy of Botox and a cosmetic filler is that over time, the scar may reappear as the Botox effect wears off and the contents of the filler are metabolized and removed by the skin. So the smoothness of the skin may only last for six months.

Alternatively, David Goldberg reported in the September edition of the Journal of Cosmetic and Laser Therapy that using a substance called calcium hydroxylapatite as a filler did improve certain acne scarring. However the treatment did not enhance ice-pick acne scarring. According to Goldberg, the diminished scar appearance lasted up to 12 months.

Is Botox the smart choice for acne scarring? Just give it the Cosmetic Three Rs test- the rates, the risks and the results. Botox injections and cosmetic fillers can cost between $150-$300 per treatment. The risks include facial swelling, redness and skin allergies.

Plus you want to make certain that your doctor is using FDA approved Botox for treating patients, not illegal versions that may not work or worse are too potent and lead to fatal botulism- a rare paralytic illness caused by the toxins of the bacterium Clostridium botulinum.

The results achieved with Botox and injections may be satisfying, but they also may only last for a few months which means that you could spend $600 plus a year to maintain the scar free look. But ultimately, if you do decide to make Botox apart of your long term plan for acne scar correction, you may feel relieved to know that a study in the December edition of the European Journal of Neurology deemed Botox to be safe and effective for long term use.