Effect of UV Irradiation on Cutaneous Cicatrices: A Randomized, Controlled Trial with Clinical, Skin Reflectance, Histological, Immunohistochemical and Biochemical Evaluations

Abstract

The aim of this study was to examine the effect of ultraviolet (UV) irradiation on human cutaneous cicatrices. In this randomized, controlled study, dermal punch biopsy wounds served as a wound healing model. Wounds healed by primary or second intention and were randomized to postoperative solar UV irradiation or to no UV exposure. Evaluations after 5 and 12 weeks included blinded clinical assessments, skin reflectance measurements, histology, immunohistochemistry, and biochemical analyses of the N-terminal propeptide from procollagen-1, hydroxyproline, hydroxylysine, and proline. Twelve weeks postoperatively, UV-irradiated cicatrices healing by second intention: (i) were significantly pointed out as the most disfiguring; (ii) obtained significantly higher scores of colour, infiltration and cicatrix area; and (iii) showed significantly higher increase in skin-reflectance measurements of skin-pigmentation vs. non-irradiated cicatrices. No histological, immunohistochemical or biochemical differences were found. In conclusion, postoperative UV exposure aggravates the clinical appearance of cicatrices in humans.

Current Therapeutic Approach to Hypertrophic Scars

“…In low-risk patients, we should just monitor wounds and prescribe silicone sheeting products for worried individuals (70). Other general measures to prevent HS formation include compression therapy, the use of moisturizers, manual massage, and strict UV photoprotection measures during scar formation and maturation phase to avoid hyperpigmentation (71, 72). As a rule, scars should be reevaluated 4–8 weeks after surgery to determine further management.…”

Acute Ultraviolet Radiation Perturbs Epithelialization but not the Biomechanical Strength of Full‐thickness Cutaneous Wounds

“…In healthy volunteers chronic UVR exposure of punch biopsy wounds made on the buttocks significantly aggravated the cosmetic appearance . UVR had no significant effect on either type I collagen synthesis or total collagen content in the wounds in that human study .…”

“…Chronic UVA and UVB irradiation altered normal skin structure and reduced wound tensile strength in the hairless guinea pig model . In healthy volunteers chronic UVR exposure of punch biopsy wounds made on the buttocks significantly aggravated the cosmetic appearance . UVR had no significant effect on either type I collagen synthesis or total collagen content in the wounds in that human study .…”

Evaluación colorimétrica digital de cicatrices patológicas: Estudio comparativo entre gel de silicona y fotoprotector

“…Conocemos los efectos adversos que las radiaciones ultravioleta generan en la apariencia de las cicatrices humanas (11). Sin embargo el gel de silicona aplicado de forma tópica parece aportar una oclusión que disminuye el depósito de colágeno en la cicatriz (12), lo que en la clínica se presenta como un tratamiento de primera elección frente a la cicatrización patológi-ca (1,13,14).…”