Therapy of keloid and hypertrophic scars: A review

Scar management for the prevention of excessive scar formation has always been important but never so important as it is today. Optimal management continues to be an enigma for surgeons, and the best modality of treatment has been debated for many years. However, most studies have unfortunately been either retrospective or case report descriptions. Advances in scar management have been hampered by confusing or ambiguous terminology. There is no consensus on what amount of posttraumatic skin scar formation is "normal" and what should be considered "hypertrophic." In the World Health Organization's ICD-9, there is no diagnostic code for hypertrophic scar-only keloid is listed (Roseborough et al. J Natl Med Assoc 96(1):108-116, 2004). Yet the medical and scientific literature distinguishes them as different conditions. This confusion results in inappropriate management of scar formation, and occasionally contributes to decision-making related to elective or cosmetic surgery. Our experience suggests that there is no single treatment for scars that is adequate and that clinical judgment is very important when considering treatment and balancing the potential benefits of the various treatments available. The goal of treating scars is to restore function, provide relief of symptoms, enhance appearance, and prevent recurrence. This article is based on our scientific and clinical experiences and it focuses on over-the-counter options to manage keloid and hypertrophic scars. © 2011 Springer-Verlag.