title: Updated international clinical recommendations on scar management: part 2--algorithms for scar prevention and treatment.
abstract: BACKGROUND
  In 2002, an international advisory panel was convened to assess the scientific literature and develop evidence-based guidance for the prevention and treatment of pathologic scarring. Emerging clinical data, new treatment options, and technical advances warranted a renewed literature search and review of the initial advisory panel recommendations.
  
  
  OBJECTIVE
  To update the management algorithm for pathologic scarring to reflect best practice standards at present.
  
  
  METHODS
  Management recommendations were derived from clinical evidence amassed during a comprehensive literature search and from the clinical experience and consensus opinion of advisory panel members.
  
  
  RESULTS
  A combination approach using multiple modalities provides the maximum potential for successful treatment of hypertrophic scars and keloids. The advisory panel advocates a move toward more aggressive initial management of keloids, including earlier application of 5-fluorouracil. A growing body of clinical research supports a place in therapy for newer agents (e.g., bleomycin, onion extract, imiquimod, mitomycin C) and laser therapy (pulsed-dye, fractional) for scar management.
  
  
  CONCLUSIONS
  Prevention and treatment of pathologic scarring requires individualized care built upon the principles of evidence-based medicine and continues to evolve in step with technological and scientific advances.
authors: *Gold Skin Care Center and Tennessee Clinical Research Center, Nashville, Tennessee; †University of California, Los Angeles, Los Angeles, California; ‡The University of Southern California, Los Angeles, CA; §Division of Plastic and Reconstructive Surgery, Northwestern University, Chicago, Illinois; ‖Memorial Sloan-Kettering Cancer Center, New York, New York; ¶Department of Dermatology, Manipal Hospital, Bangalore, India; #Miami Dermatology and Laser Institute, Miami, Florida; **Inkwell Medical Communications, Novelty, Ohio.
authors: Michael H
authors: MH
authors: Gold
authors: Michael
authors: M
authors: McGuire
authors: Thomas A
authors: TA
authors: Mustoe
authors: Andrea
authors: A
authors: Pusic
authors: Mukta
authors: M
authors: Sachdev
authors: Jill
authors: J
authors: Waibel
authors: Crystal
authors: C
authors: Murcia
mesh_terms: D000465:Algorithms; D002921:Cicatrix / Q000145:classification / Q000473:pathology / Q000517:prevention & control / Q000628:therapy*; D006801:Humans; D012879:Skin Physiological Phenomena