Hypertrophic Scars and Keloids: Advances in Treatment and Review of Established Therapies

Frech, Fabio Stefano; Hernandez, Loren; Urbonas, Rebecca; Zaken, Ghufran Abo; Dreyfuss, Isabella; Nouri, Keyvan

doi:10.1007/s40257-022-00744-6

Cited by 33 publications

(21 citation statements)

References 213 publications

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“…There are many ways for the prevention and treatment of HS, generally divided into surgical treatment, pressure therapy, laser therapy, cryotherapy, and combination therapies. − However, the current situation of HS treatment worldwide is still unsatisfactory, and many problems remain. Surgery is one of the most common treatment strategies for HS, but it has a high recurrence rate and usually needs to be combined with drug therapy or radiation therapy.…”

Section: Introductionmentioning

confidence: 99%

Preparation of Compound Salvia miltiorrhiza–Blumea balsamifera Nanoemulsion Gel and Its Effect on Hypertrophic Scars in the Rabbit Ear Model

Chen,

Wang,

Gong

et al. 2024

Mol. Pharmaceutics

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Hypertrophic scars (HS) still remain an urgent challenge in the medical community. Traditional Chinese medicine (TCM) has unique advantages in the treatment of HS. However, due to the natural barrier of the skin, it is difficult for the natural active components of TCM to more effectively penetrate the skin and exert therapeutic effects. Therefore, the development of an efficient drug delivery system to facilitate enhanced transdermal absorption of TCM becomes imperative for its clinical application. In this study, we designed a compound Salvia miltiorrhiza−Blumea balsamifera nanoemulsion gel (CSB-NEG) and investigated its therapeutic effects on rabbit HS models. The prescription of CSB-NEG was optimized by single-factor, pseudoternary phase diagram, and central composite design experiments. The results showed that the average particle size and PDI of the optimized CSB-NE were 46.0 ± 0.2 nm and 0.222 ± 0.004, respectively, and the encapsulation efficiency of total phenolic acid was 93.37 ± 2.56%. CSB-NEG demonstrated excellent stability and skin permeation in vitro and displayed a significantly enhanced ability to inhibit scar formation compared to the CSB physical mixture in vivo. After 3 weeks of CSB-NEG treatment, the scar appeared to be flat, pink, and flexible. Furthermore, this treatment also resulted in a decrease in the levels of the collagen I/III ratio and TGF-β 1 and Smad2 proteins while simultaneously promoting the growth and remodeling of microvessels. These findings suggest that CSB-NEG has the potential to effectively address the barrier properties of the skin and provide therapeutic benefits for HS, offering a new perspective for the prevention and treatment of HS.

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Section: Introductionmentioning

confidence: 99%

Preparation of Compound Salvia miltiorrhiza–Blumea balsamifera Nanoemulsion Gel and Its Effect on Hypertrophic Scars in the Rabbit Ear Model

Chen,

Wang,

Gong

et al. 2024

Mol. Pharmaceutics

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“…[17][18][19][20] However, the low efficiency and high risks of recurrence limit the further clinical applications of these therapies. 13,21 Therapies with high efficiency for the treatment of HSs and for the early intervention of HS formation are highly required.…”

Section: Introductionmentioning

confidence: 99%

Zeolitic imidazolate framework-90 loaded with methylprednisolone sodium succinate effectively reduces hypertrophic scar in vivo

Xu,

Liu,

Xiao

et al. 2024

Nanoscale

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“…5,6 Laser therapies have emerged as promising keloid management options, with performance varying by laser types and lesion characteristics. 7,8 A systematic review of the outcomes of laser therapy in patients with excessive scarring found CO 2 and Er:YAG 2940 nm lasers most effective in improving lesion height, pliability, and erythema. 9 Common adverse effects include hyper/hypopigmentation and blistering.…”

Section: Introductionmentioning

confidence: 99%

“…Cryotherapy is limited to small‐sized keloids, is associated with prolonged healing times and can result in permanent pigmentation, skin atrophy, and severe pain 5,6 . Laser therapies have emerged as promising keloid management options, with performance varying by laser types and lesion characteristics 7,8 . A systematic review of the outcomes of laser therapy in patients with excessive scarring found CO 2 and Er:YAG 2940 nm lasers most effective in improving lesion height, pliability, and erythema 9 .…”

Section: Introductionmentioning

confidence: 99%

Effective keloid management using a combinatorial continuous‐wave and repeat fractionated ablative CO₂ laser regimen

Arellano‐Huacuja

2024

J of Cosmetic Dermatology

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BackgroundKeloids are benign proliferative scars that form as a result of dysregulated growth and collagen deposition in response to cutaneous injury. Laser therapies have emerged as promising options for the treatment of keloids, with performance varying by laser type and lesion characteristics.PurposeTo assess the combined continuous wave and repetitive fractionated CO2 laser treatment of keloids.MethodsA retrospective chart review of 22 cases of keloid scars treated with combined CO2 laser modes. A single session of continuous wave followed by five sessions of fractional delivery. Efficacy was assessed using the Patient and Observer Scar Assessment Scale (POSAS) and the Vancouver Scar Scale. The Numeric Rating Scale was used to assess patient satisfaction and pain.ResultsMost patients were female (77.3%) with skin type IV (72.7%), age was 24.3 ± 9.3 years, most keloids were located on the earlobe (56.5%) or arm or hand (17.4%), size ranged from 5 to 10 cm, and time since injury ranged from 3 months to 35 years. No serious adverse events were reported. At 6 months, significant improvements from baseline occurred in all characteristics, scar color (4.8 ± 2.8 to 1.9 ± 1.1), rigidity (5.0 ± 2.8 vs. 5.4 ± 2.8), thickness (5.4 ± 2.8 vs. 2.0 ± 1.1), and irregularity (5.9 ± 2.4 vs. 1.9 ± 0.9). The Vancouver scores followed a similar trend. Patient‐rated overall improvement from 37 ± 17.6 at baseline to 16.1 ± 8.5 at 6 months, and improvement in associated pain and pruritus.ConclusionCombination of two ablative laser delivery modes within a single laser platform provided for effective and safe keloid management and left patients highly satisfied.

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Hypertrophic Scars and Keloids: Advances in Treatment and Review of Established Therapies

Cited by 33 publications

References 213 publications

Preparation of Compound Salvia miltiorrhiza–Blumea balsamifera Nanoemulsion Gel and Its Effect on Hypertrophic Scars in the Rabbit Ear Model

Preparation of Compound Salvia miltiorrhiza–Blumea balsamifera Nanoemulsion Gel and Its Effect on Hypertrophic Scars in the Rabbit Ear Model

Zeolitic imidazolate framework-90 loaded with methylprednisolone sodium succinate effectively reduces hypertrophic scar in vivo

Effective keloid management using a combinatorial continuous‐wave and repeat fractionated ablative CO₂ laser regimen

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Hypertrophic Scars and Keloids: Advances in Treatment and Review of Established Therapies

Cited by 33 publications

References 213 publications

Preparation of Compound Salvia miltiorrhiza–Blumea balsamifera Nanoemulsion Gel and Its Effect on Hypertrophic Scars in the Rabbit Ear Model

Preparation of Compound Salvia miltiorrhiza–Blumea balsamifera Nanoemulsion Gel and Its Effect on Hypertrophic Scars in the Rabbit Ear Model

Zeolitic imidazolate framework-90 loaded with methylprednisolone sodium succinate effectively reduces hypertrophic scar in vivo

Effective keloid management using a combinatorial continuous‐wave and repeat fractionated ablative CO2 laser regimen

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Product

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Effective keloid management using a combinatorial continuous‐wave and repeat fractionated ablative CO₂ laser regimen