Current Treatments for Hypertrophic Scars & Keloids | A Review

This research article was published online in January 2022 in the Plastic and Reconstructive Surgery Journal

This article reviews the most recent advancements in the prevention and treatment algorithms for thick scars and keloids. The first advancement is the use of a highly effective and potent steroid known as deprodone propionate plaster. This method is a standard treatment protocol in Japan and has wonderful data.  Based on clinical experiences and observational studies, it has become the preferred treatment in hypertrophic scar and keloid therapy in the United States, especially among experts in scar revision. Dr. Ezaldein typically uses corticosteroid tape early on and with other non-surgical approaches before considering other treatments. 

The paper highlights the importance of tension-reducing stitching techniques as the best approach to reduce the re-development of a keloid. The core excision technique, for example, avoids strain on the wound by removing only the hypertrophic reticular layer of the keloid. This technique is well-suited for keloids on the ears (after a piercing, for instance) or on the rest of the body. Sometimes a combination of scar removal and other treatment modalities can be needed for tougher keloids and other thick scars.

There are numerous studies that have strengthened the treatment and prevention of hypertrophic scars and keloids. Keep in mind, that treatments may need to be adjusted based on the patient’s ethnicity and race. Dr. Ezaldein emphasizes that long-term follow-up appointments greater than 18 to 24 months are the most beneficial for determining the durability of treatment response. Additionally, patient education on scar management is essential for a favorable outcome. This research paper is an important addition because it reviews the efficacy of recent advances in the treatment of hypertrophic scars and keloids.