The efficacy of steroid tape for hypertrophic and keloid scars assessed using the SCAR-Q patient-reported outcome measure

Abstract

Background: Japanese people have a higher prevalence of hypertrophic and keloid scars than people of other ethnicities. Steroid tape is a simple, conservative treatment utilized broadly for scars in Japan but is largely overlooked elsewhere in the world. This study evaluated the efficacy of steroid tape for scars using a scar-specific patient-reported outcome measure, the Japanese SCAR-Q.

Methods: A single-center, prospective cohort study of all patients treated with steroid tape for pathologic scars, including hypertrophic and keloid scars, was conducted. Primary outcome measures included SCAR-Q scores (both current and recalled baseline), and global rating of change scores.

Results: One-hundred sixty-three patients were enrolled. The overall response rate was 95.7%. Steroid tape use was associated with significant improvements in SCAR-Q scores of 14.4 ± 16.5, 17.6 ± 17.7, and 15.1 ± 18.4 points for the Appearance, Symptom, and Psychosocial Impact scales, respectively. Global rating of change scores for scar appearance, associated symptoms, and psychosocial impact were also largely improved in >90% of patients. Steroid tape was easy to use and associated with few minor side effects. Post-treatment, Japanese patients continued to report hiding behaviors and a desire to change/remove their scar.

Conclusions: Steroid tape was associated with patient-reported scar improvement, and the treatment strategy should therefore be considered for conservative pathologic scar management. Nonetheless, Japanese patients still experienced significant psychosocial impacts from their scars after treatment. The personal impact of scars in this sample may be partially related to unique features of the Japanese culture.

Keywords: Cross-cultural investigation; Hypertrophic scars; Keloids; Patient-reported outcome measures; SCAR-Q; Scars; Steroids.