Nonsurgical management of periocular scars along with review of literature

Abstract

Introduction: Facial scars in the periocular region may cause cosmetic blemish as well as functional deficits. There are several treatment options available for scar management, but many of these are unsuitable for periocular region because of their potential to cause damage to the ocular structures. This article aims to present an ophthalmic plastic surgeon's perspective of managing these scars safely and effectively. Methods: An extensive literature search was done using PubMed (Medline), Cochrane, and Google Scholar with multiple combinations of search terms such as scar, facial scar, contracture, and keloid. Articles in English language published describing the existing and emerging modalities of treatment for periocular facial scars were reviewed. Results: The scarring pattern in the face and periocular area is different as wound healing in these areas differs from that of the rest of the body. Various techniques ranging from simple scar massage to laser and intralesional steroids and antimetabolites have been described with good results for managing scars in various parts of the body. However, safety of some of these modalities in periocular region has not been established unequivocally as yet. Conclusion: Effective scar management requires a multipronged therapeutic approach. Facial and periocular scars deserve special care due to their close proximity to the eyes. Hence, it is paramount that safety of any approach be ascertained prior to the procedure, especially in periocular areas.