Current Best Evidence for 5 Promising Medications Used for Scar Minimization Therapy

Introduction: Wound healing by fibrosis allows for closure of a wound, but leaves behind a permanent scar with physical and psychological effects. The primary aim of this narrative review was to summarize the current status of the evidence supporting the use of oral or topical medications to minimize scarring in humans. Methods: With the help of a health sciences librarian, PubMed, Embase, and Scopus were searched up to March 31, 2023, to investigate potential medications to ameliorate scarring. Based on this search, the medications pirfenidone, losartan, trichostatin A, enalapril, and atorvastatin were identified as 5 therapies with the most research to support their use. Studies discussing noncutaneous scarring (myocardial, intraabdominal, etc) or in animal models were excluded. Results: There is a paucity of quality literature describing the use of oral or topical medications to minimize fibrosis and produce more favorable scarring. Six studies describing the medications listed above all demonstrated an improvement in scarring parameters, most commonly based on the Vancouver Scar Scale. Conclusions: Though preliminary, emerging evidence suggests that therapies already exist with the potential to improve cutaneous scarring. Some of these medications are already ubiquitous, affordable and have a known safety profile. Excitingly, these treatments are either oral or topical, meaning that they are more accessible for patients than some current modalities for scar treatment, including steroid injections or laser therapy. Further larger-scale trials are needed before these treatments can be recommended as a routine part of scar management.