title: A Combination Approach to Surgical Scars.
abstract: BACKGROUND
  Scar formation from surgical procedures is an unavoidable risk. Despite measures taken by both the surgeon and patient during the perioperative and postoperative periods to maximize cosmesis, some patients will wish to pursue surgical or laser scar revision.
  
  
  OBJECTIVE
  The authors propose a treatment algorithm to assist in approaching surgical scar revision with combination treatments.
  
  
  METHODS
  A PubMed search was performed on various surgical scar revision techniques. The authors augment these findings with their own personal experiences.
  
  
  RESULTS
  Reports of surgical excision, intralesional corticosteroid injection, intralesional 5-fluorouracil injection, pulse dye laser treatment, nonablative fractional laser resurfacing, ablative fractional laser resurfacing, and microneedling and fractional needle radiofrequency, used in isolation or combination, were found. The authors also provide clinical photographs documenting improvement in appearance of surgical scars using these treatments.
  
  
  CONCLUSIONS
  Surgical scars are best treated with a combination approach to address various features of the scar. The authors propose a treatment algorithm with multiple treatment options and how to combine them safely and effectively.
authors.affiliation: *Department of Dermatology, University of California San Diego, San Diego, California; †Scripps Clinic, Laser and Cosmetic Dermatology, San Diego, California; ‡Department of Dermatology, University of Colorado, Boulder, Colorado.
authors.forename: Robert E
authors.initials: RE
authors.lastname: Eilers
authors.forename: Edward Victor
authors.initials: EV
authors.lastname: Ross
authors.forename: Joel L
authors.initials: JL
authors.lastname: Cohen
authors.forename: Arisa E
authors.initials: AE
authors.lastname: Ortiz
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage; D001284:Atrophy / Q000628:therapy; D002921:Cicatrix / Q000209:etiology / Q000473:pathology* / Q000628:therapy*; D003131:Combined Modality Therapy; D003357:Cosmetic Techniques; D004890:Erythema / Q000628:therapy; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D015552:Injections, Intralesional; D053685:Laser Therapy; D009339:Needles; D000078702:Radiofrequency Therapy; D013514:Surgical Procedures, Operative / Q000009:adverse effects
chemical_list: D000305:Adrenal Cortex Hormones; D000964:Antimetabolites, Antineoplastic; D005472:Fluorouracil