Treatment approaches for treating hypertrophic scars and keloids

Background and Purpose Hypertrophic and keloid scars can have a dramatic impact on the quality of life for patients. Their complexity and multimodal nature also present significant challenges to physicians. Each scar presentation is unique due to influences such as the source of injury and specific healing properties of the patient. As such, each treatment must be equally individual. The goal of this study is to provide the tools to navigate complex hypertrophic and keloid scar treatment by outlining treatment algorithms that can be tailored to each specific presentation. Methods The authors combined a review of rising clinical research and consensus papers with lessons drawn from clinical practice to create comprehensive treatment recommendations. Results A wide variety of treatment options were incorporated into the algorithms which were drawn from world scar expert consensus including moisturization/compression, surgery, laser therapy, and laser‐assisted drug delivery. Scars of all ages were included and should be treated, though age should factor into treatment intensity. Particularly with hypertrophic and keloid scars, location and resulting tension is a primary consideration in treatment strategy. In keloid scars, radiation therapy can also play a role. Conclusion The authors propose that a combination treatment strategy customized to scar type, depth, texture, and dyschromia is necessary to produce optimal results. Early intervention is preferable though not essential to achieve scar mitigation. With careful and appropriate treatment algorithms, patients with debilitating scarring may recover significant function, cosmesis, and overall quality of life.