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Hypertrophic scars and keloids: etiology and management
Tina S Alster1, Elizabeth L Tanzi
1The Washington Institute of Dermatologic Laser Surgery, DC 20037, USA. talster@skinlaser.com
American Journal of Clinical Dermatology
|April 12, 2003
Summary
Keloid and hypertrophic scars, caused by excess collagen, present treatment challenges. While prevention is key, various therapies exist, with biologic agents showing future promise for managing these difficult scars.
Area of Science:
- Dermatology
- Wound Healing
- Scar Management
Background:
- Keloid and hypertrophic scars are common, disfiguring conditions resulting from excessive collagen deposition.
- The exact cause of aberrant collagen proliferation in these scars remains elusive.
- Despite numerous published articles, a universally accepted treatment protocol is lacking.
Purpose of the Study:
- To review the pathophysiology and clinical characteristics of keloid and hypertrophic scars.
- To discuss current treatment strategies and their limitations.
- To explore potential future therapeutic avenues, including biologic agents.
Main Methods:
- Literature review of existing studies on keloid and hypertrophic scar management.
- Analysis of clinical presentations and underlying pathophysiological mechanisms.
- Evaluation of the efficacy of various treatment modalities.
Main Results:
- No single treatment is universally effective for keloid and hypertrophic scars.
- Prevention is the optimal strategy, especially for predisposed individuals.
- Current treatments include radiation, pressure therapy, cryotherapy, intralesional injections, silicone dressings, and laser therapy.
Conclusions:
- Effective management requires understanding scar pathophysiology.
- Surgical excision alone often leads to recurrence; adjunct therapies are necessary.
- Biologic agents targeting collagen proliferation may offer future therapeutic advancements.