Current Therapeutic Approach to Hypertrophic Scars

Area of Science:

• Dermatology
• Wound Healing
• Regenerative Medicine

Background:

• Abnormal scarring, particularly hypertrophic scars (HSs), presents significant aesthetic, functional, and psychological challenges.
• Current understanding of HS formation mechanisms is incomplete, hindering the development of satisfactory prevention and treatment options.
• Existing therapies are often empirical, yielding unreliable and unpredictable outcomes for impaired skin healing.

Purpose of the Study:

• To review current therapeutic approaches and emerging strategies for managing hypertrophic scars.
• To highlight the need for individualized treatment plans based on scar evaluation and patient expectations.
• To explore novel therapeutic avenues targeting specific molecular mechanisms for effective scar management.

Main Methods:

• Review of current literature on hypertrophic scar pathophysiology and treatment modalities.
• Analysis of established and experimental therapeutic options, including combination therapies.
• Exploration of emerging strategies focusing on the extracellular matrix and molecular targets like bone morphogenetic proteins.

Main Results:

• Combination therapy (steroid injections, 5-fluorouracil, pulsed-dye laser) appears most effective among current options.
• No single current treatment reliably overcomes impaired skin healing in hypertrophic scars.
• Targeting extracellular matrix components, particularly through modulation of bone morphogenetic proteins, shows potential for new therapeutic approaches.

Conclusions:

• Individualized treatment for hypertrophic scars is crucial, integrating scar assessment, patient expectations, and evidence-based guidelines.
• There is a significant unmet need for targeted therapies with clarified mechanisms of action for effective hypertrophic scar prevention and treatment.
• Modulating extracellular matrix, specifically bone morphogenetic proteins, represents a promising frontier for achieving functionally and cosmetically acceptable scar outcomes.