AzTrials
AzTrials

Wound of SkinPhase 2/3NCT03452072

Efficacy and Safety of 0.25% Timolol Gel in Healing Surgical Open Wounds

A Phase 2/3 study testing 0.25% Timolol gel with paraffin gauze dressings and Vaseline dressing in people with Wound of Skin and Wound Heal, run by Brigham and Women's Hospital at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

The use of topical beta-blockers, such as 0.25% timolol, in promoting wound healing is currently emerging in the academic literature. The investigators will enroll 114 patients who have their skin cancer surgically removed resulting in open surgical wounds less or equal to 1.5 cm. Read more about this study

Who is it for?
Ages 18 years and olderHealthy volunteers can take part
Conditions the study is for
Wound of Skin, Wound Heal, Wound Open
What is being tested?
0.25% Timolol gel with paraffin gauze dressings and Vaseline dressing
Could I receive a placebo?
No, everyone receives an active treatment
How many people
87 participants
Where
1 siteUnited States
Study dates
20 Aug 2018to 30 Jun 2021
Phase
Phase 2/3
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • Age greater than 18 years
  • Open surgical wound ≤1.5cm
  • No hypersensitivity with use of 0.25% timolol gel

Who cannot join

  • Age less than 18 years of age
  • Open surgical wound >1.5cm
  • Pregnant women
  • Use of systemic retinoids within 1 month
  • Any hypersensitivity with use of 0.25% timolol gel

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Mohs and Dermatologic Surgery Center, Brigham and Women's Hospital

    Boston, Massachusetts, 02130

Other trials in United States

About this study

Official title: Efficacy and Safety of 0.25% Timolol Gel in Healing Surgical Open Wounds: A Randomized Controlled Trial

The use of topical beta-blockers, such as 0.25% timolol, in promoting wound healing is currently emerging in the academic literature. The investigators will enroll 114 patients who have their skin cancer surgically removed resulting in open surgical wounds less or equal to 1.5 cm. The objective of this randomized safety study is to determine the safety and efficacy of 0.25% timolol in promoting wound healing in open surgical wounds less or equal to 1.5 cm.

Read the detailed description

Healing of a cutaneous defect by second intention is a complex process. Migration of fibroblasts, keratinocytes, and other cell types to the site of defect and their proliferation under stimulation by cytokines and growth factors occur during this process. The role of topical beta-blockers in promoting wound healing is currently emerging in the international literature (1-3). β2-Adrenergic receptors (B2AR) are the only subtype of beta-adrenoceptors expressed on skin (4-6). They can be found in secretory coil of apocrine glands, keratinocytes, fibroblasts and melanocytes. The distribution of these receptors provides insight on dermatological disorders that may be affected by β-blockers. Keratinocyte migration occurs by the facilitation of chemotaxis, the polarization of cells, and activation of extracellular signal-related kinases essential in the signaling of promigratory pathways. The B2AR activation inhibits keratinocyte migration by activating the serine/threonine phosphatase 2A, which downregulates phosphorylation of extracellular signal-related kinases necessary for migration. Therefore, B2AR antagonists prevent the phosphorylation of phosphatase 2A and have the downstream effect of extracellular signal-related kinase promotion, inducing a promigratory pathway in keratinocytes (4-6). Keratinocyte migration also occurs by galvanotaxis, a phenomenon in which cells migrate in response to electric stimuli. Keratinocytes can be stimulated to migrate with the formation of electrical poles and the application of electrical fields. The B2AR antagonists improve the ability of keratinocytes to respond to such migratory cues, whereas the B2AR agonists decrease keratinocytes' ability to respond, further implicating the use of topical timolol for recalcitrant wounds (4-6). Angiogenesis and dermal fibroblast proliferation are also regulated by B2ARs. The B2AR antagonists have been found to promote angiogenesis in chick chorioallantoic membrane assays and in vivo murine wound models. Dermal fibroblast migration is also increased (by 27%) when exposed to B2AR antagonists, and epidermal differentiation is improved with B2AR antagonists and β1- and β2-receptor antagonists (5-10).

Topical beta-blockers have been gaining increasing popularity and evidence over the last few years as enhancers of wound healing in acute and chronic open wounds. In particular, 0.25% timolol gel may represent a commercially available, safe and simple, painless-though perhaps moderately expensive-treatment for improving both acute and chronic open wounds, as well as for improving long-term cosmetic outcomes.

To assess the efficacy and safety of topically applied 0.25% timolol gel in promoting wound healing in surgical open wounds ≤1.5cm versus standard of care (SOC) by:

  1. Evaluating healing in response to treatment with 0.25% topical timolol gel versus SOC in terms of wound surface area reduction of open surgical wound;
  2. Evaluating cosmetic outcomes of surgical wounds in terms of blinded physician (Vancouver Scar Scale, VSS) and patient (Visual Analogue Scale, VAS) assessment at 3 and 6 months follow up;
  3. Evaluating patient discomfort during the healing process by means of a patient pain VAS;
  4. Determining the side effects associated to 0.25% topical timolol versus SOC; and
  5. Determining costs associated to the use of 0.25% topical timolol versus SOC.
Being tested
0.25% Timolol gel with paraffin gauze dressings, Vaseline dressing
Medical subject headings
Surgical Wound

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • 0.25% Timolol gel with paraffin gauze dressingsDrug

    Timolol 0.25% gel will be applied to wound bed immediately after surgery before dressing is applied. Starting the day after surgery: each day, the patient will cleanse the surgical site, apply 0.25% topical timolol gel (1 drop = 0.1ml for each cm2 of wound area), and re-cover wound with clean dressing

  • Vaseline dressingOther

    Vaseline will be applied to wound bed immediately after surgery before dressing is applied. Starting the day after surgery: each day, the patient will cleanse the surgical site, apply Vaseline, and re-cover wound with clean dressing

Study groups in NCT03452072
Study groupRoleWhat they receive
0.25% Timolol gel under the paraffin gauzesExperimental1. Timolol 0.25% gel will be applied to wound bed immediately after surgery before dressing is applied 2. Starting the day after surgery: each day, the patient will cleanse the surgical site, apply 0.25% topical timolol gel (1 drop = 0.1ml for each cm2 of wound area), and re-cover wound with clean dressing 3. This daily routine continues for 12 weeks' post-surgery (even if the surgical defect has completely healed in the interim)
Receives: Drug: 0.25% Timolol gel with paraffin gauze dressings
Standard of Care dressingsActive comparator1. Vaseline will be applied to wound bed immediately after surgery before dressing is applied 2. Starting the day after surgery: each day, the patient will cleanse the surgical site, apply Vaseline, and re-cover wound with clean dressing 3. This daily routine continues for 12 weeks' post-surgery (even if the surgical defect has completely healed in the interim)
Receives: Other: Vaseline dressing

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Number of Participants With Re-epithelialization at 30 Days Post op

    Evaluating the difference in wound re-epithelialization at 30 days after surgery between the groups. Re-epithelialization (yes vs. no) will be evaluated by 2 independent investigators.

    Measured: 30 days' post-surgery

Secondary outcomes (3)
  1. Cosmetic Outcomes of Open Surgical Wound Healing by Blinded Physician Vancouver Scar Scale Assessment

    A physician blinded to the treatment group the subject is in will self-administer the Vancouver Scar Scale (VSS) which documents change in scar appearance over time via standardized photographs. The VSS ranges from 0 (most desirable outcome) to 13 (least desirable outcome), thus, a lower score is considered to have a better outcome and a higher score is considered a worse outcome. The VSS consists of four sub-scales, with each sub-scale reporting a value. The "pigmentation sub-scale" ranges from 0 (normal pigmentation) to 2 (hyperpigmentation); the "vascularity sub-scale" ranges from 0 (normal appearance) to 3 (purple appearance); the "pliability sub-scale" ranges from 0 (normal pliability) to 5 (contracture); and the "height sub-scale" ranges from 0 (normal [flat]) to 3 (>5mm). Sub-scale scores are combined to give an overall VSS assessment score.

    Measured: 3 months' post-surgery

  2. Study Subject Complete the Patient Scar Assessment Via Visual Analogue Scale

    Subjects will be asked to complete a Visual Analogue Scale for scar assessment to rate how they think their graft sites appear cosmetically compared to normal skin. The score ranges from 1 (no complaints with how scar appears cosmetically to normal skin) to 10 (worst imaginable scar compared to normal skin). A lower score is considered to have a better outcome and a higher score is considered a worse outcome.

    Measured: 6 months' post-surgery

  3. Number of Participants Whose Side Effects Are Associated With 0.25% Topical Timolol for Open Surgical Wounds

    Patients will report and side effects they experience post-surgery. A physician will also assess for side effects and determine whether they are likely associated with the 0.25% topical timolol or part of the normal wound healing experience.

    Measured: Up to 6 months' post-surgery

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted2 Mar 2018
  2. Study start20 Aug 2018
  3. Primary completion29 Dec 2020
  4. Study completion30 Jun 2021

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2/3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
The protocol will begin post-surgery. Eligible subjects will be assigned by computer-based randomization to case (0.25% timolol gel) or control (standard of care \[SOC\]) group and treated as follows: Case group: 1. Timolol 0.25% gel will be applied to wound bed immediately after surgery before dressing is applied 2. Starting the day after surgery: each day, the patient will cleanse the surgical site, apply 0.25% topical timolol gel (1 drop = 0.1ml for each cm2 of wound area), and re-cover wound with clean dressing 3. Daily routine continues for 12 weeks' post-surgery (even if the surgical defect has completely healed) SOC group: 1. Vaseline will be applied to wound bed immediately after surgery before dressing is applied 2. Starting the day after surgery: each day, the patient will cleanse the surgical site, apply Vaseline, and re-cover wound with clean dressing 3. This daily routine continues for 12 weeks' post-surgery (even if the surgical defect has completely healed)
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
87 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03452072
Sponsor's protocol ID
BWHMDSC001
Status last verified
Mar 2026
First submitted
16 Feb 2018
Last updated
14 May 2026
Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
Undecided

Publications

  • Braun LR, Lamel SA, Richmond NA, Kirsner RS. Topical timolol for recalcitrant wounds. JAMA Dermatol. 2013 Dec;149(12):1400-2. doi: 10.1001/jamadermatol.2013.7135. No abstract available.

    PubMed 24172892
  • Ali A, Herndon DN, Mamachen A, Hasan S, Andersen CR, Grogans RJ, Brewer JL, Lee JO, Heffernan J, Suman OE, Finnerty CC. Propranolol attenuates hemorrhage and accelerates wound healing in severely burned adults. Crit Care. 2015 May 4;19(1):217. doi: 10.1186/s13054-015-0913-x.

    PubMed 25936635
  • Vestita M, Bonamonte D, Filoni A. Topical propranolol for a chronic recalcitrant wound. Dermatol Ther. 2016 May;29(3):148-9. doi: 10.1111/dth.12328. Epub 2016 Jan 22. No abstract available.

    PubMed 26800510
  • Yesiloglu N, Yildiz K, Cem Akpinar A, Gorgulu T, Sirinoglu H, Ozcan A. Histogram Planimetry Method for the Measurement of Irregular Wounds. Wounds. 2016 Sep;28(9):328-333.

    PubMed 27701128
  • Thomas B, Kurien JS, Jose T, Ulahannan SE, Varghese SA. Topical timolol promotes healing of chronic leg ulcer. J Vasc Surg Venous Lymphat Disord. 2017 Nov;5(6):844-850. doi: 10.1016/j.jvsv.2017.04.019. Epub 2017 Aug 7.

    PubMed 29037357
  • Manahan MN, Peters P, Scuderi S, Surjana D, Beardmore GL. Topical timolol for a chronic ulcer--a case with its own control. Med J Aust. 2014 Jan 20;200(1):49-50. doi: 10.5694/mja13.10823. No abstract available.

    PubMed 24438420
  • Lev-Tov H, Dahle S, Moss J, Isseroff RR. Successful treatment of a chronic venous leg ulcer using a topical beta-blocker. J Am Acad Dermatol. 2013 Oct;69(4):e204-5. doi: 10.1016/j.jaad.2013.06.003. No abstract available.

    PubMed 24034405
  • Tang JC, Dosal J, Kirsner RS. Topical timolol for a refractory wound. Dermatol Surg. 2012 Jan;38(1):135-8. doi: 10.1111/j.1524-4725.2011.02200.x. Epub 2011 Oct 31. No abstract available.

    PubMed 22093053
  • Zheng Z, Liu Y, Yang Y, Tang J, Cheng B. Topical 1% propranolol cream promotes cutaneous wound healing in spontaneously diabetic mice. Wound Repair Regen. 2017 May;25(3):389-397. doi: 10.1111/wrr.12546. Epub 2017 May 26.

    PubMed 28494521

Questions about this trial

What is this clinical trial studying?

A Phase 2/3 study testing 0.25% Timolol gel with paraffin gauze dressings and Vaseline dressing in people with Wound of Skin and Wound Heal, run by Brigham and Women's Hospital at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 14 May 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this combined phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 14 May 2026). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Number of Participants With Re-epithelialization at 30 Days Post op (time frame: 30 days' post-surgery). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03452072, which also lists 9 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 14 May 2026.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in