Topical treatments in the management of keloids and hypertrophic scars: a critically appraised topic.

Abstract

Keloids and hypertrophic scars remain a frustrating and common entity posing continued challenges. A case of an 8‐year‐old girl with a painful keloid scar on the right arm subsequent to a history of varicella zoster virus inspired us to review the available evidence on the best treatment modality, given her substantial needle phobia. There is a plethora of treatment options available in the pursuit of their notoriously difficult elimination; however, none is more accessible, cheap or patient centric than topical treatments.1 We searched the MEDLINE and Embase databases and the Clinical Trials Registry from inception to 7 January 2022. The findings are summarized in a PRISMA flow diagram (https://doi.org/10.6084/m9.figshare.19874242.v1). The studies exhibited a high degree of heterogeneity in designs and methods with notable variation in outcome measurement across studies, and therefore meta‐analysis was not performed. The Cochrane Risk of Bias tool (Figure 1) emphasizes further the impact of selection, performance and detection bias, alongside the prevalence of incomplete outcome data.