Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Nov-Dec;31(6):731-737.
doi: 10.1111/wrr.13120. Epub 2023 Oct 15.

Evaluating skin colour diversity in the validation of scar assessment tools

Stuti P Garg  1 , Tokoya Williams  1 , Iulianna C Taritsa  1 , Rou Wan  2 , Chirag Goel  1 , Raiven Harris  1 , Kristin Huffman  1 , Robert D Galiano  1
Affiliations

Evaluating skin colour diversity in the validation of scar assessment tools

Stuti P Garg et al. Wound Repair Regen. 2023 Nov-Dec.

Abstract

Across scar studies, there is a lack of dark-skinned individuals, who have a predisposition for keloid formation, altered pigmentation and poorer quality of life (QOL). There is a need for patients of colour to be included in scar scale development and validation. In this study, we evaluate the racial diversity of patients included in the validation of scar assessment scales. A systematic review was conducted for articles reporting on the validation of a scar assessment tool. Racial, ethnic and Fitzpatrick skin type (FST) data were extracted. Fifteen scar scale validation studies were included. Nine of the studies did not mention FST, race or ethnicity of the patients. Two of the studies that reported FST or race information only included White patients or included no FST V/VI patients: mapping assessment of scars (MAPS) and University of North Carolina '4P'. Only four studies included non-White patients or dark-skinned patients in the validation of their scar scale: the modified Vancouver Scar Scale (VSS), modified Patient and Observer Scar Assessment Scale (POSAS), acne QOL and SCAR-Q scales. The patients included in the modified VSS validation were 7% and 13% FST V/VI, 14% African in the modified POSAS and 4.5% FST V/VI in the SCAR-Q. We highlight the severe lack of diversity in scar scale validation, with only 4 out of 15 studies including dark-skinned patients. Given the susceptibility of darker-skinned individuals to have poorer scarring outcomes, it is critical to include patients of colour in the very assessment tools that determine their scar prognosis. Inclusion of patients of colour in scar scale development will improve scar assessment and clinical decision-making.

Keywords: dark-skinned patients; patients of colour; scar scale validation; scarring.

PubMed Disclaimer

References

REFERENCES

    1. Ferguson MWJ, Whitby DJ, Shah M, Armstrong J, Siebert JW, Longaker MT. Scar formation: the spectral nature of fetal and adult wound repair. Plast Reconst Surg. 1996;97(4):854-860.
    1. Choo AMH, Ong YS, Issa F. Scar assessment tools: how do they compare? Front Surg. 2021;8:643098.
    1. Durani P, McGrouther DA, Ferguson MW. Current scales for assessing human scarring: a review. J Plast Reconstr Aesthet Surg. 2009;62(6):713-720.
    1. Fearmonti R, Bond J, Erdmann D, Levinson H. A review of scar scales and scar measuring devices. Eplasty. 2010;10:e43.
    1. Chung J-H, Kwon S-H, Kim K-J, et al. Reliability of the Patient and Observer Scar Assessment Scale in evaluating linear scars after thyroidectomy. Adv Skin Wound Care. 2021;34(6):1-6.

Publication types

LinkOut - more resources