Skip to Main Content

ABSTRACT

The landscape of scar therapy research is in an exciting state of intensive investigation, with dozens of promising therapies being tested to evaluate their expanded role in scar treatment. Various emerging pharmacologic treatments may be able to mitigate scars as they evolve or after they are mature. It may also be possible to facilitate healing and reduce scarring by employing mechanical ways to modulate tension on the skin near a wound. Investigators are also studying how we might correct scarring with stem cells, which express scarless healing signaling pathways. One of the critical research questions is identifying which stem cell niches are most relevant. While much promising research is underway, there remains a dearth of randomized controlled trials to test the comparative effectiveness of different treatment strategies. Further, despite the abundance of potential treatment candidates currently being investigated in preclinical testing, there is a relative paucity of drugs and devices in phase II and III clinical trials.

INTRODUCTION

While current first-line scar management options have proven to be invaluable in the prevention and amelioration of scars, they may not provide substantial clinical efficacy in all patients.1,2 In particular, traumatic and burn scars are often complicated by the deep and severe damage caused by the injurious agent, as well as the accompanying comorbidities and pain associated with these injuries.3 The complexity of these scars makes treatment particularly difficult, and conventional options sometimes cannot produce good functional and aesthetic outcomes for patients. Scarring can also lead to debilitating psychosocial impairment from anxiety, depression, and reduced social functioning, especially in burn patients.4 Patients suffering from such scars may find enormous benefit from evolutions in scar management technologies and strategies. Because of the need for improved scar management, the landscape of scar therapy research is in an exciting state of intensive investigation, with dozens of promising therapies being tested to evaluate their expanded role in scar treatment. This chapter will briefly discuss current scar therapies and their limitations and then survey a selection of the most notable candidate therapies that are currently emerging in the literature (Table 17-1).

Table 17-1Current and Emerging Scar Treatments

CURRENT SCAR THERAPIES

A standard scar treatment algorithm was recently developed by an international, multidisciplinary team of experts who evaluated the appropriate roles of established therapies based on current evidence.5 These current mainstays of hypertrophic and keloid scar management include pressure dressings, silicone gel sheeting, hydration, massage, antihistamines, surgical revision, ...

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.