Keloids and hypertrophic scars

BACKGROUND. Keloids and hypertrophic scars are benign fibrous growths that occur after trauma or wounding of the skin and present a major therapeutic dilemma to the dermatologist because of frequent recurrences. OBJECTIVE. The purpose of this study is to review the pertinent literature and provide updated information on keloids and hypertrophic scars that will enable the physician to better understand and treat these lesions. METHODS. A Medline literature search was performed for relevant publications. RESULTS. Traditional treatment methods which have been effective include a combination of surgery with intralesional steroids and/or radiotherapy, silicone gel sheeting, pressure, and cryotherapy. Recently newer modalities shown to be effective include pulsed dye laser, interferon alfa-2b, and cultured epithelial autografts. CONCLUSION. Keloids and hypertrophic scars present a major therapeutic dilemma to the dermatologist because of frequent recurrences. A better understanding of keloid pathogenesis may lead to improved therapies by which keloid growth and regrowth may be obviated. Although optimal treatment for keloids remains undefined, successful treatment can be obtained through a multimodality approach. Regardless of the technique employed, an observation period of at least 2 years is necessary to rule out recurrence.