Background: Hypertrophic scars lead to aesthetic and local symptoms . Moreover these scars have psychological effects such as embarrassment and low self-confidence. Many treatment modalities had been used, but each one has its limited effect.

Objectives: The aim of the study is toevaluate the role of hypertrophic scars management by comparing intralesional injection of Botulinum Toxin (BTX-A) to intralesional injection of triamcinolone .

Subjects and methods: This study was carried on 20 patients with hypertrophic scars, their scars were divided into two equal sectors, one sector was injected with BTX-A while the other sector was injected with corticosteroid (triamcinolone) as a control. Assessment of the results were achieved objectively and digitally photographed using the same camera, lightening setting and patient positioning before treatment, at one-month, three months and six months' visits. The hypertrophic scar score was calculated before and after treatment by patient and observer scar assessment scale (POSAS).

Results: There was statistically significant improvement in both BTX-A and triamcinolone injected scars. The different parameters that assessed by POSAS showed better improvement and significant lower scores in the BTX-A injected areas without side effects. The triamcinolone injected scars showed complication such as atrophy, hypopigmentations. The results of the study revealed that BTX-A has a significant role in treatment of hypertrophic scars with minimal side effects.

Conclusion: In conclusion, intralesional injection of BTX-A is suitable for treatment of recent hypertrophic scars with decreasing associated pain and itching and better tolerated than corticosteroid.