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Scar treatments have been around for as long as there have been scars. The Egyptians, Romans, and Chinese developed remedies to promote the healing of wounds without scars. Common agents that have been used on traumatic wounds for years include honey, aloe, cocoa, and oak bark. Wilhelm Fabry wrote the first modern treatise on burns in the seventeenth century and addressed their healing, as well as the management of the resulting hypertrophic and contracted scars. Within the last century, the science of scar prevention and treatment has advanced, aided by discoveries and technologies that emerged to treat wounded warriors.
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The term “scar” comes from the Greek word “eskara” meaning scab, or eschar caused by a burn injury. The current use of the word “scar” applies to any visible mark after a pathologic wound-healing process. In ancient Egypt, scars or marks were used as identifiers, providing uniqueness to an individual. For example, “Charetos, one-scar-small-finger-right handed,” or “Maron, eldest son of Onnopresu, aged 40, born with a scar on his forehead.”1 Other than treating wounds to prevent infection or life-altering disfigurement, scar treatment centered on symptomatic relief from itching or pain. In modern cultures, scars became clouded under a much more negative light. Even in contemporary cinematic representations, many villains harbor identifying scars intended to evoke fear, disgust, and disdain. Societal focus on beauty and perfection, many times to a degree of unattainable ideals, has made scars unwanted and unwelcome. Severe scars disfigure the souls and quality of life of those afflicted. Therefore, knowledge of the treatment of these scars is of utmost importance to the physician. In this chapter, we provide a brief glimpse into the past as we discuss the history of scar treatment.
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The prevention of scar formation and promotion of healthy healing after thermal or traumatic injury is a field of much interest and research dating back to the ancient Egyptians, Romans, and Chinese. Ancient topical remedies used to treat wounds to aid in scarless healing included amniotic membrane, boiled potato peel, cocoa, oak bark, and honey, among many more (Table 1-1).2 Whether rooted in mythology, superstition, folklore, or objective evidence, these medicines were used in the hope of safer, cleaner wound healing, and minimal disfigurement.
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Economical and easily available, honey has been used for at least 2700 years to treat traumatic wounds, burns, chronic ulcers, and cutaneous infections.2 The evidence behind honey as a ...