Treatment of hypertrophic scars and keloids: a review

Abstract

Objective: The purpose of this study was to provide a review of the diagnosis and treatment of hypertrophic scars and keloids. Data Sources: A MEDLINE search was conducted for pertinent English-language articles published from 1966 to 1999. Study Selection: All studies concerning the pathophysiology and treatment of hypertrophic scars and keloids were reviewed. Data Extraction: Publications with clinically relevant data were selected for discussion in the article. Data Synthesis: Hypertrophic scars and keloids can pose a formidable therapeutic challenge. Numerous treatments are available. These include intralesional corticosteroids, topical applications, surgery, and, most recently, laser therapy. Silicone sheeting and cryotherapy are among the useful adjunctive agents for hypertrophic scar and keloid treatment. Vitamin E, onion extract derivative, and aloe vera have not proved to be effective. Surgery provides an invasive but sometimes necessary alternative in the treatment of scars. Radiation therapy may have a role in the treatment of recalcitrant lesions. Most recently, the pulsed-dye laser has been successfully used to treat keloids and hypertrophic scars. Conclusions: Currently, no definitive therapy exists for the treatment of keloids and hypertrophic scars. The advent of laser technology, particularly the pulsed-dye laser, appears to offer the best hope for successful treatment. Combination therapy seems to offer increased efficacy.