title: Updated international clinical recommendations on scar management: part 1--evaluating the evidence.
abstract: BACKGROUND
  There is an ongoing need to standardize scar management by establishing safe and effective treatment options that can be applied in routine clinical practice.
  
  
  OBJECTIVE
  To review available data on methods for preventing and treating cutaneous scarring.
  
  
  METHODS
  Relevant scientific literature was identified through a comprehensive search of the MEDLINE database. Additional data and published studies were submitted for consideration by members of the International Advisory Panel on Scar Management.
  
  
  RESULTS
  One of the most significant advances in scar management over the past 10 years has been the broader application of laser therapy, resulting in a shift in status from an emerging technology to the forefront of treatment. Accumulated clinical evidence also supports a greater role for 5-fluourouracil in the treatment of hypertrophic scars and keloids, particularly in combination with intralesional corticosteroids. Encouraging data have been reported for newer therapies, including bleomycin, onion extract-containing preparations, imiquimod, and mitomycin C, although methodologic limitations in available studies merit consideration. In general, clinical and aesthetic outcomes seem to be enhanced by a combination approach to treatment.
  
  
  CONCLUSIONS
  Advances in therapeutic options and new study data necessitate a revision of algorithms for the prevention and management of cutaneous scarring.
authors: *Gold Skin Care Center and Tennessee Clinical Research Center, Nashville, Tennessee; †Center for Clinical and Cosmetic Research, Aventura, Florida; ‡Department of Laser and Surgery, Istituto Dermatologico Europeo, Milano, Italy; §Department of Dermatology and Allergy, Ludwig Maximilian University, Munich, Germany; ‖Paces Plastic Surgery, Atlanta, Georgia; ¶Inkwell Medical Communications, Novelty, Ohio.
authors: Michael H
authors: MH
authors: Gold
authors: Brian
authors: B
authors: Berman
authors: Matteo Tretti
authors: MT
authors: Clementoni
authors: Gerd G
authors: GG
authors: Gauglitz
authors: Foad
authors: F
authors: Nahai
authors: Crystal
authors: C
authors: Murcia
mesh_terms: D002921:Cicatrix / Q000628:therapy*; D019317:Evidence-Based Medicine; D006801:Humans; D017410:Practice Guidelines as Topic; D012879:Skin Physiological Phenomena