title: Topical verapamil as a scar modulator.
abstract: BACKGROUND
  Skin injuries and the consequent loss of tissue integrity triggers a sequence of cellular and biochemical events that lead to a healed wound. Any failure during this rather sophisticated process may result in pathological scarring.
  
  
  METHODS
  To evaluate the efficacy of topical verapamil as a modulator of the healing process, a group of five observers (plastic surgeon, dermatologist, physiotherapist, biologist, and layman) analyzed pictures of 120 patients 3 months after abdominoplasty (60 patients) and mammoplasty (60 patients). Half of each group of patients used the topical verapamil scar modulator. Pictures were rated using the Stony Brook Scale.
  
  
  RESULTS
  According to the classification established by us, the scars in patients who used topical verapamil scar modulator showed better results than those who did not (p < 0.05). Patients treated with verapamil presented good-quality scarring (80 % of mammoplasty scars and 75.2 % abdominoplasty scars), while patients who did not use healing modulators showed 48 and 51.2 % satisfaction for mammoplasty and abdominoplasty scars, respectively. No adverse reactions were observed or reported after the use of topical verapamil.
  
  
  CONCLUSIONS
  This is the first clinical trial that reports the use of topical verapamil as a modulator in the healing process in the postoperative period. Based on clinical results and on the high level of reliability and statistical significance, we concluded that verapamil at a concentration of 50 µM is an excellent choice as a scar modulator; its use avoids the development of keloids and hypertrophic scars after plastic surgery.
authors.affiliation: Department of Cell and Development Biology, Institute of Biomedical Science, University of São Paulo, Av. Prof. Lineu Prestes, 1524, ICB I rooms 306/307, Butantan, São Paulo, SP, 05508-900, Brazil, ricardoboggio@ricardoboggio.com.br.
authors.forename: Ricardo Frota
authors.initials: RF
authors.lastname: Boggio
authors.forename: Leonardo Frota
authors.initials: LF
authors.lastname: Boggio
authors.forename: Bruno Luiz
authors.initials: BL
authors.lastname: Galvão
authors.forename: Glaucia Maria
authors.initials: GM
authors.lastname: Machado-Santelli
mesh_terms: D061645:Abdominoplasty; D000287:Administration, Topical; D000328:Adult; D000368:Aged; D002121:Calcium Channel Blockers / Q000008:administration & dosage*; D017439:Cicatrix, Hypertrophic / Q000517:prevention & control*; D006801:Humans; D007627:Keloid / Q000517:prevention & control*; D016462:Mammaplasty; D008875:Middle Aged; D014700:Verapamil / Q000008:administration & dosage*; D014945:Wound Healing / Q000187:drug effects*
chemical_list: D002121:Calcium Channel Blockers; D014700:Verapamil