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Each patient's scar was randomly divided into 2 equal parts, with 1 part receiving TAC + BTX-A and the other BTX-A alone for 3 sessions at 4-week intervals. Scar thickness was measured with calipers, and the Vancouver Scar Scale (VSS) was administered to assess scar condition. Pain and pruritus were evaluated with a numeric rating scale (NRS) and visual analog scale (VAS), respectively, before each intervention (V1, V2, V3) and 4 weeks after the last session (V4). In the animal study, rats with burn scars were assigned to 5 groups: sham, untreated burn, TAC, BTX-A, and TAC + BTX-A. Scar thickness and expressions of alpha smooth muscle actin (\u03b1-SMA), transforming growth factor beta (TGF-\u03b2), connective tissue growth factor (CTGF), collagen I\/III, laminin, and fibronectin were analyzed histologically.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Clinically, both therapies reduced scar thickness, VSS, NRS, and VAS scores. However, combination therapy showed superior reductions in scar thickness (V2-V4) and VSS scores (V3, V4) compared to BTX-A monotherapy. No significant differences were observed in NRS and VAS scores. The animal study confirmed that combination therapy more effectively reduced scar thickness, TGF-\u03b2 and CTGF levels, and the collagen I\/III ratio, and increased the laminin\/fibronectin ratio.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>TAC + BTX-A combination therapy enhances scar reduction by more effectively suppressing fibroblast proliferation and activation through TGF-\u03b2 and CTGF downregulation, promoting scar remodeling.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/asj\/sjaf094","type":"journal-article","created":{"date-parts":[[2025,6,6]],"date-time":"2025-06-06T01:32:05Z","timestamp":1749173525000},"page":"1073-1085","source":"Crossref","is-referenced-by-count":3,"title":["Enhanced Scar Reduction With Triamcinolone Acetonide and Botulinum Toxin A Combination Therapy Compared to Botulinum Toxin A Monotherapy: A Translational Pilot Study"],"prefix":"10.1093","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2903-1703","authenticated-orcid":false,"given":"Shu-Hung","family":"Huang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen-Chin","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui-Yu","family":"Chuang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shih-Ming","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shang-Yu","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4675-6615","authenticated-orcid":false,"given":"Sheng-Hua","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,6,6]]},"reference":[{"key":"2025091917035594900_sjaf094-B1","doi-asserted-by":"publisher","first-page":"adv00582","DOI":"10.2340\/00015555-3923","article-title":"Pruritus 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