Is Verteporfin Good To Help Lessen Scarring?
Q: Dr. Eppley, I was wondering your thoughts or if you were using verteporfin with the idea of helping treat and or reducing scaring and conserving hair in incisions made during surgical procedures. I know it’s a new treatment being used in some hair transplants clinics with what looks to be great results so I was curious on your opinion on the subject and if you think it’s something that would be beneficial. Thank you very much for your time.
A:Verteporfin, aka Visudyne, is anFDA approved injection as part of Photodynamic therapy for leaky blood vessels in ophthalmology. Its mechanism of action is cytotoxic to endothelial cells when activated by light in the presence of oxygen. Its off label use for scars, while more commonly done now, is being espoused as having a positive effect presumably through its antifibrinolytic action and inhibition of collagen cross-linking. I have no experience with it so I can not say if it has a positive effect or not. The evidence for its benefits is certainly anecdotal but that doesn’t mean it does not work.
Like all therapies being used that have uncertain benefits the real question becomes not its benefits but the risks of using it. If the benefits are uncertain (touted but not scientifically proven) and the risks are zero of any side effects than the only question to be debated with its use is economic. (how much does it cost) This explains the historic use of PRP, for example, and more currently TXA. But if there are adverse side effects in the face of questionable benefits then I would say don’t use it. When it comes to Verteporfin used as a direct injection into the incisional closure/scar I am not aware of any significant adverse effects. The unknown variables are dose and frequency of injections.
Dr. Barry Eppley
World-Renowned Plastic Surgeon