Current and Emerging Strategies in the Management of Keloid Scars: A Comprehensive Review

Area of Science:

• Dermatology
• Wound Healing
• Immunology

Background:

• Keloids are pathological scars with distinct characteristics like invasion beyond borders, pain, and high recurrence.
• Current treatments target aberrant immune responses but often yield inadequate clinical responses.
• Management challenges persist due to patient-specific factors, scar location, and etiology.

Purpose of the Study:

• To provide a comprehensive review of keloid and hypertrophic scar treatment strategies.
• To summarize the shortcomings of existing therapeutic options.
• To offer recommendations on dosage and duration for available treatments.

Main Methods:

• Literature review of current and novel therapeutic strategies for keloids and hypertrophic scars.
• Analysis of conservative management options (e.g., pressure therapy, silicone, topical agents, steroid injections).
• Evaluation of invasive approaches (e.g., surgical excision, radiation therapy, chemotherapeutic agents) and novel therapies (e.g., calcium-channel blockers, mesenchymal stem cells).

Main Results:

• Conservative and invasive treatments show variable efficacy, often dependent on individual patient factors.
• High recurrence rates persist despite multimodal treatment approaches.
• Novel therapies show promise but require further investigation for optimal application.

Conclusions:

• Keloid management remains challenging, necessitating a review of current and emerging treatment modalities.
• A combination of therapies is often required, but recurrence is common.
• Further research is crucial to optimize novel treatments like calcium-channel blockers and mesenchymal stem cells for keloid management.