Current use of steroids in management of abnormal raised skin scars

Scars are a natural part of dermal healing processes and consist of networks of fibrous collagen tissue, laid down in response to injury to the dermis. In some genetically susceptible individuals, the process of scar tissue formation is excessive, and there is an over-secretion of collagen. This causes the formation of benign tumours (raised) scars known as keloid and hypertrophic scars. Scars can have many significant functional, cosmetic and psychological sequelae. Steroids are used therapeutically in the management of abnormal scars; however, this is associated with a variety of adverse effects. Their intralesional administration is the most widely used and most effective treatment modality for raised skin scars today. Despite this, our understanding of the way in which they work is poor and literature on the topic is, to date, lacking. Further work is needed to clarify the exact mechanisms that bring about abnormal scarring, to aid our understanding of the disease and facilitate the development of more evidence-based treatment strategies.