Improving facial scar outcomes: an evidence-based update

Facial scarring represents a significant clinical and psychosocial burden for patients. This review summarizes current evidence for prophylactic and therapeutic scar management techniques relevant to ear, nose, and throat surgeons, covering risk stratification, wound closure principles, dressings, intralesional agents, laser therapy, radiation, and adjunctive treatments.

The evidence base for facial scar management continues to expand, with recent meta-analyses, and RCTs improving our understanding of both conservative and surgical treatment strategies. While established therapies are further validated, emerging combination approaches and novel adjuncts are broadening the therapeutic treatment repertoire. Key areas of progress include non-invasive dressing products, intralesional pharmacotherapy, energy-based devices, and radiation protocols, though significant gaps in high-quality evidence particularly for the head and neck region is an ongoing issue.

Facial scar management requires identification of modifiable risk factors, appropriate scar classification, and tailored evidence-guided selection of therapies. No single universal treatment exists, and treatment plans must be patient focussed. High-quality randomized controlled trials specific to the head and neck region remain limited, and multicentre collaborative research is needed to establish consensus guidelines.