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Review
. 2014 Aug;69(8):565-73.
doi: 10.6061/clinics/2014(08)11.

Update on hypertrophic scar treatment

Felipe Bettini Rabello  1 , Cleyton Dias Souza  2 , Jayme Adriano Farina Júnior  3
Affiliations
Review

Update on hypertrophic scar treatment

Felipe Bettini Rabello et al. Clinics (Sao Paulo). 2014 Aug.

Abstract

Scar formation is a consequence of the wound healing process that occurs when body tissues are damaged by a physical injury. Hypertrophic scars and keloids are pathological scars resulting from abnormal responses to trauma and can be itchy and painful, causing serious functional and cosmetic disability. The current review will focus on the definition of hypertrophic scars, distinguishing them from keloids and on the various methods for treating hypertrophic scarring that have been described in the literature, including treatments with clearly proven efficiency and therapies with doubtful benefits. Numerous methods have been described for the treatment of abnormal scars, but to date, the optimal treatment method has not been established. This review will explore the differences between different types of nonsurgical management of hypertrophic scars, focusing on the indications, uses, mechanisms of action, associations and efficacies of the following therapies: silicone, pressure garments, onion extract, intralesional corticoid injections and bleomycin.

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Conflict of interest statement

No potential conflict of interest was reported.

Figures

Figure 1
Figure 1
Hypertrophic scar regression in a burned child after four years (A and B). Hypertrophic scars are usually raised, although rarely elevated more than 4 mm above the skin; red or pink in color; hard; and pruritic. Additionally, these scars do not extend beyond the general geographic margins of the wound and tend to regress over time.
Figure 2
Figure 2
Keloid evolution after seven years (A and B). Keloids continue to evolve over time, without a quiescent or regressive phase, and infiltrate the surrounding tissue.
Figure 3
Figure 3
The histology of hypertrophic scars is characterized by replacement of the papillary and reticular dermis by scar tissue with prominent vertically oriented blood vessels. The fibrous bundles are parallel and horizontal in the upper dermis. (Masson's trichrome, 100X).
Figure 4
Figure 4
The histology of keloids is characterized by well-demarcated and disorganized fibrous tissue usually involving the upper half or two-thirds of the dermis. The collagen fibers are noticeably thicker (Masson's trichrome, 100X).
See this image and copyright information in PMC

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