Update on hypertrophic scar treatment

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.

Novel Insights on Understanding of Keloid Scar: Article Review

“…17 Although these kinds of dressings are commonly used to decrease the incidence rate of keloid and hypertrophic scars after surgical procedures, 20 complete resolution has not been reported. 1,18 Onion Extract and Heparin Gel 12 The exact mechanism by which onion extract reduces scar formation is still poorly understood. Onion extract has fibroblast-inhibiting ability that decreases fibroproliferative activity and synthesis of extracellular matrix (ECM), and increases the expression of matrix metalloproteinase MMP-1.…”

“…Moreover, hypertrophic scar is red or pink in color, firm, pruritic, does not extend beyond the margins of the wound, and tend to regress over time. 11,12 Until now, the pathology of keloid scars is not well understood and the precise mechanism of its pathogenesis is still unknown. 6 Scientists consider an abnormal cellular proliferation of fibroblasts as the key reason of keloid scar formation.…”

The Use of Silicone Adhesives for Scar Reduction

“…23 SGS has also been found to inhibit the body's natural reaction to increase skin capillaries through hyperemia. 24 This reduces the blood supply to the scar site and the exaggeration of the healing process, along with the intensity of the fully formed scar's appearance and physical properties. The mechanism by which SGS has this effect has not yet been eluded, but research has prompted the idea that a significant temperature increase of the scar site is involved with the alteration of localized blood flow.…”

Distinct Expression Profiles of lncRNAs Between Regressive and Mature Scars

“…Abnormal scars, including hypertrophic scars and keloids, cause functional and cosmetic issues, are characterized by excessive collagen deposition and exhibit increased extracellular matrix production [2,3.] Numerous factors have been reported to participate in the wound healing process, such as transforming growth factor beta (TGF-β), interleukin-6, homeobox B13 and platelet-derived growth factor [4].…”