Management of Keloids and Hypertrophic Scars

Area of Science:

• Dermatology
• Wound Healing Research
• Regenerative Medicine

Background:

• Keloid and hypertrophic scars stem from abnormal wound healing in the reticular dermis.
• They are characterized by disorganized extracellular matrix and excessive collagen production.
• Current prevention strategies target high-risk individuals and focus on minimizing tension and inflammation.

Purpose of the Study:

• To review and synthesize current understanding and treatment modalities for keloid and hypertrophic scars.
• To evaluate the efficacy of various interventions, from conservative measures to advanced therapies.
• To provide insights into optimal prevention and treatment strategies based on scientific evidence.

Main Methods:

• Review of existing literature on scar management.
• Analysis of different treatment approaches including topical therapies, cryotherapy, corticosteroid injections, OnabotulinumtoxinA, laser treatments, and surgical revisions.
• Evaluation of prevention strategies and timing of interventions.

Main Results:

• Topical treatments (gel sheets, corticosteroids) and intralesional cryotherapy can reduce scarring.
• Corticosteroid injections are effective for both prevention and treatment.
• OnabotulinumtoxinA shows superiority over fluorouracil and corticosteroids for scar treatment.
• Laser therapies and surgical revisions, especially with tension-reducing techniques and combined modalities, offer advanced options.
• Postoperative corticosteroid injections (10-14 days) are superior for keloid prevention.
• Radiation therapy is a safe adjuvant or standalone treatment with low cancer risk.

Conclusions:

• Effective management of keloid and hypertrophic scars requires a multi-faceted approach.
• Treatment selection depends on scar type, patient risk factors, and desired outcomes.
• Combining therapies, optimizing timing of interventions, and utilizing advanced modalities can improve results.