title: Currently known risk factors for hypertrophic skin scarring: A review.
abstract: OBJECTIVE
  The study aims to provide an overview of risk factors for hypertrophic scarring.
  
  
  BACKGROUND
  Hypertrophic skin scarring remains a major concern in medicine and causes considerable morbidity. Despite extensive research on this topic, the precise mechanism of excessive scarring is still unknown. In addition, the current literature lacks an overview of the possible risk factors in the development of hypertrophic scars.
  
  
  METHODS
  PubMed searches were performed on risk factors for hypertrophic scar (HTS) formation.
  
  
  RESULTS
  Eleven studies suggesting nine factors associated with HTS formation were found. Studies concerning chemotherapy, age, stretch, infection, and smoking have a moderate to high strength of evidence, but some other factors have not been studied in a convincing manner or are still disputed.
  
  
  CONCLUSIONS
  Risk factors for HTS formation are young age, bacterial colonization, and skin subjected to stretch. Chemotherapy, statins, and smoking seem to play a protective role in HTS formation.
authors.affiliation: Department of Plastic, Reconstructive and Hand Surgery, VU University Medical Center, Amsterdam, The Netherlands. Electronic address: l_butzelaar@yahoo.com.
authors.forename: L
authors.initials: L
authors.lastname: Butzelaar
authors.affiliation: Association of Dutch Burn Centers, Beverwijk, The Netherlands; Department of Molecular Cell Biology and Immunology, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: M M W
authors.initials: MM
authors.lastname: Ulrich
authors.affiliation: Department of Plastic, Reconstructive and Hand Surgery, University Medical Center, Utrecht, The Netherlands.
authors.forename: A B
authors.initials: AB
authors.lastname: Mink van der Molen
authors.affiliation: Department of Plastic, Reconstructive and Hand Surgery, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: F B
authors.initials: FB
authors.lastname: Niessen
authors.affiliation: Department of Molecular Cell Biology and Immunology, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: R H J
authors.initials: RH
authors.lastname: Beelen
mesh_terms: D017439:Cicatrix, Hypertrophic / Q000453:epidemiology / Q000209:etiology / Q000473:pathology; D014943:Global Health; D006801:Humans; D009017:Morbidity / Q000639:trends; D012307:Risk Factors; D012867:Skin / Q000473:pathology*; D014945:Wound Healing
keywords: Excessive scarring; Hypertrophic scar; Risk factors; Skin; Wound healing