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Scar Treatment: Evidence-Based Methods from Silicone to Laser

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Scar Treatment: Evidence-Based Methods from Silicone to Laser

Scars range from minor pigmentation to thick keloid. Following the international consensus by Mustoe et al., we summarise non-invasive, injection-based and laser options.

Published8 min read

Modern scar therapy combines prevention, the right modality for the scar type, and long-term follow-up.

Scar types

  • Mature — flat, normal-coloured
  • Hypertrophic — raised, within original wound boundary
  • Keloid — raised, extends beyond the wound
  • Atrophic — depressed (acne, varicella)
  • Contracture — post-burn, restricts movement

First-line: silicone

International consensus (Mustoe 2002, Gold 2014) supports silicone gel/sheets for prevention and treatment of hypertrophic scars; 12–24 hours/day for 2–6 months.

Intralesional corticosteroid

Triamcinolone acetonide (10–40 mg/mL) every 4–6 weeks is first-line for keloid and persistent hypertrophic scars.

Lasers

  • PDL — vascular, red scars
  • Non-ablative fractional (Er:Glass 1540) — texture
  • Ablative fractional (CO₂, Er:YAG) — deep atrophic scars

References

  1. Mustoe TA, et al. International recommendations on scar management. Plast Reconstr Surg. 2002;110(2):560–571. https://doi.org/10.1097/00006534-200208000-00031
  2. Gold MH, et al. Updated international recommendations on scar management. Dermatol Surg. 2014;40(8):825–831. https://doi.org/10.1111/dsu.0000000000000050
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