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Management of keloids and hypertrophic scars: current and emerging options

Authors Gauglitz GG

Published Date April 2013 Volume 2013:6 Pages 103—114

DOI http://dx.doi.org/10.2147/CCID.S35252

Received 15 February 2013, Accepted 11 March 2013, Published 24 April 2013

Gerd G Gauglitz

Department of Dermatology and Allergy, Ludwig-Maximilian University, Munich, Germany

Abstract: In the context of growing aesthetic awareness, a rising number of patients feel disappointed with their scars and are frequently seeking help for functional and aesthetic improvement. However, excessive scarring following surgery or trauma remains difficult to improve despite a plethora of advocated treatment strategies as frequently observed in daily clinical routine. It is thus still preferable to prevent scarring by minimizing risk factors as much as possible. Hence, it remains crucial for the physician to be aware of basic knowledge of healing mechanisms and skin anatomy, as well as an appreciation of suture material and wound closure techniques to minimize the risk of postoperative scarring. Next to existing, well known prophylactic and therapeutic strategies for the improvement of excessive scarring, this article discusses emerging techniques such as intralesional cryotherapy, intralesional 5-fluorouracil, interferon, and bleomycin. Some of them have been successfully tested in well-designed trials and already have extended or may extend the current spectrum of excessive scar treatment in the near future. Innovative options such as imiquimod 5% cream, photodynamic therapy, or botulinum toxin A may also be of certain importance; however, the data currently available is too contradictory for definite recommendations.

Keywords: intralesional cryotherapy, lasers, triamcinolone acetonide, TGF-β

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