Advances in scar management: prevention and management of hypertrophic scars and keloids

Drew Del Toro, Raj Dedhia, Travis Tate Tollefson

Research output: Contribution to journalReview articlepeer-review

42 Scopus citations


Purpose of review Abnormal scarring remains a poorly understood but functional and aesthetic consequence of surgical and traumatic wounds. The purpose of this review is to describe the current state of the science behind the prevention and management of these scars. Recent findings A recent update in the International Clinical Recommendations on Scar Management provides a wealth of information on new and revised treatments for hypertrophic scars and keloids. Silicone-based products continue to be the premier option for prevention and initial treatment of hypertrophic and keloid scars. There is growing evidence demonstrating the efficacy of intralesional corticosteroids and 5-fluorouracil. Laser therapy remains a second-line treatment option, with low-level evidence supporting the use of pulse dye lasers and ablative fractional lasers. Summary Although there remains no 'gold standard' for the prevention and treatment of hypertrophic scars and keloids, silicone gel products and microporous paper tape present the best conservative options. A stepwise algorithm for the treatment of hypertrophic scars or keloids based on the characteristics and responsiveness of the scar presents the best management strategy. Combination therapy (including steroid injections, 5-fluorouracil, and pulse dye laser) proves to be the strongest option for the nonsurgical management of severe hypertrophic scars and keloids.

Original languageEnglish (US)
Pages (from-to)322-329
Number of pages8
JournalCurrent Opinion in Otolaryngology and Head and Neck Surgery
Issue number4
StatePublished - Aug 1 2016


  • hypertrophic scar
  • keloid
  • Keywords 5-fluorouracil
  • silicone sheeting
  • steroid injection

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Surgery


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