topiramate and Cicatrix

Topiramate may be a safe and effective treatment for scars. Shapira et al. reported an open label study on ten adult subjects with discolored or raised scars at least 2 years old who were given topiramate in an oral dosage of 15 mg per day for 1 month. The dosage was then increased to 30 mg per day if there was minimal or no improvement. Based on that study, BDC Research Centre treated 91 patients with various scarring conditions including post acne, varicella, dermatitis scars, melasma, hypertrophic scars, and keloids. Excellent to good results were observed in post-acne and post-varicella scars.

Topics: Adult; Cicatrix; Female; Fructose; Humans; Male; Middle Aged; Topiramate

A 3-month open-label pilot study was carried out to assess the safety, tolerability, and effect of the antiepilectic topiramate on the cosmetic appearance of scars. Ten adult subjects with discolored or raised scars at least 2 years old were given an oral dosage of 15 mg per day of topiramate for 1 month. The dosage was then increased to 30 mg per day if there was minimal or no improvement. The safety of topiramate was assessed in this study by reviewing adverse events and vital signs. Efficacy outcomes included a Clinician Global Impression Scale (CGI) to document changes such as thickness and color. Digital photos were taken with consistent variables. In addition, two independent medical reviewers blindly reviewed the photos. The Rosenberg Self-Esteem Scale was done at each visit to measure patients' levels of self-esteem. Side effects were generally mild with the most common being language problems (n = 3) and sleep disturbances (n = 3). All subjects completed the study and experienced at least minimal thinning and decreased coloration (usually redness) of their scars. Based on CGI-assessment data at 3 months, two subjects were very much improved, four were much improved, and four had minimal improvement. One independent medical reviewer arranged before and after treatment picture sets for ten out of ten subjects. The other independent medical reviewer arranged before and after treatment pictures sets for nine out of ten subjects (both p-values less than 0.025). The data indicate that topiramate may be a safe and effective treatment for scar therapy.

Topics: Administration, Oral; Adult; Cicatrix; Female; Fructose; Humans; Male; Mental Disorders; Middle Aged; Pilot Projects; Safety; Self Concept; Single-Blind Method; Topiramate; Treatment Outcome; Weight Loss

Recent studies have indicated that systemic topiramate can induce an improvement on the aesthetic appearance of skin scars. Here, we evaluated topical topiramate as an agent to improve wound healing in C57/BL6 mice. Mice were inflicted with a 6.0 mm punch to create two wounds in the skin of the dorsal region. Thereafter, mice were randomly assigned to either vehicle or topical topiramate (20 µl of 2% cream) once a day for 14 days, beginning on the same day as wound generation. We analyzed the wound samples over real-time PCR, Western blotting, and microscopy. There was no effect of the topiramate treatment on the time for complete reepithelization of the wound. However, on microscopic analysis, topiramate treatment resulted in increased granulation tissue, thicker epidermal repair, and improved deposition of type I collagen fibers. During wound healing, there were increased expressions of anti-inflammatory markers, such as IL-10, TGF-β1, and reduced expression of the active form of JNK. In addition, topiramate treatment increased the expression of active forms of two intermediaries in the insulin-signaling pathway, IRS-1 and Akt. Finally, at the end of the wound-healing process, topiramate treatment resulted in increased expression of SOX-2, a transcription factor that is essential to maintain cell self-renewal of undifferentiated embryonic stem cells. We conclude that topical topiramate can improve the overall quality of wound healing in the healthy skin of mice. This improvement is accompanied by reduced expression of markers involved in inflammation and increased expression of proteins of the insulin-signaling pathway.

Topics: Animals; Anti-Inflammatory Agents; Cell Self Renewal; Cicatrix; Collagen Type I; Fructose; Granulation Tissue; Humans; Insulin; Interleukin-10; Male; Mice; Mice, Inbred C57BL; Signal Transduction; Skin; SOXB1 Transcription Factors; Topiramate; Transforming Growth Factor beta; Wound Healing