title: Current Strategies in the Treatment of Scars and Keloids.
abstract: Hypertrophic scars (HTSs) and keloids are a major health concern for aesthetic and functional reasons. Despite a plethora of rapidly evolving treatment options and technical advances, the management of pathologic scarring remains difficult. The development of standardized treatment algorithms has been problematic for years due to the lack of sound randomized controlled trials. Expert panels are more and more establishing guidelines to provide an evidence-based framework on a national and international level. This article aims to evaluate the current strategies and upcoming trends in the therapy and prevention of unpleasant scars and keloids from a clinical perspective. There is strong evidence to support a growing role of early combination treatments, particularly the application of 5-fluoruracil adjunct to intralesional steroid injections. Furthermore, the use of fractional ablative laser technologies such as the CO2 laser has recently yielded promising results with respect to aesthetic outcomes and patient satisfaction at tolerable side effects.
authors.affiliation: Department of Dermatology and Allergology, Ludwig-Maximilian University, Munich, Germany.
authors.forename: Markus V
authors.initials: MV
authors.lastname: Heppt
authors.affiliation: Department of Dermatology, Eberhard-Karls University Tübingen, Tübingen, Germany.
authors.forename: Helmut
authors.initials: H
authors.lastname: Breuninger
authors.affiliation: Department of Dermatology and Allergology, Ludwig-Maximilian University, Munich, Germany.
authors.forename: Markus
authors.initials: M
authors.lastname: Reinholz
authors.affiliation: Skin and Face Clinic, Baden-Baden, Germany.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Feller-Heppt
authors.affiliation: Department of Dermatology and Allergology, Ludwig-Maximilian University, Munich, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Ruzicka
authors.affiliation: Department of Dermatology and Allergology, Ludwig-Maximilian University, Munich, Germany.
authors.forename: Gerd G
authors.initials: GG
authors.lastname: Gauglitz
mesh_terms: D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use; D017439:Cicatrix, Hypertrophic / Q000601:surgery / Q000628:therapy*; D003452:Cryosurgery; D005472:Fluorouracil / Q000627:therapeutic use; D006801:Humans; D007627:Keloid / Q000601:surgery / Q000628:therapy*; D053685:Laser Therapy; D054025:Lasers, Dye / Q000627:therapeutic use; D053844:Lasers, Solid-State / Q000627:therapeutic use; D009498:Neurotoxins / Q000627:therapeutic use; D019697:Onions; D008517:Phytotherapy; D010936:Plant Extracts / Q000627:therapeutic use; D011312:Pressure; D017655:Silicon Compounds / Q000627:therapeutic use; D013256:Steroids / Q000627:therapeutic use
chemical_list: D000964:Antimetabolites, Antineoplastic; D009498:Neurotoxins; D010936:Plant Extracts; D017655:Silicon Compounds; D013256:Steroids; D019274:Botulinum Toxins, Type A; D005472:Fluorouracil