Scientists reviewed a number of therapeutic interventions for hypertrophic scars in this research. Their study, which appeared in the journal Burns & Trauma, highlighted some that offer great promises for averting skin scarring.
The process by which wounds heal comprises three main stages. These are the inflammation stage, proliferation stage, and lastly regeneration stage.
It is not uncommon for scars to appear as wounds heal. However, a type known as a hypertrophic scar (HS) is a concern due to how it can adversely impact the look and feel of the skin.
Hypertrophic scarring is difficult to deal with. The interventions revealed in the current paper could make it easier to prevent them.
About Hypertrophic Scars
Hypertrophic scarring involves excessive accumulation of disordered collagen under the skin. The scars are marked and, in many cases, raised.
The skin condition is the result of issues in the phases of the wound healing process. Scientists, however, do not fully understand the mechanisms underlying its development.
This type of scar is not only a concern to the people affected because of its appearance, but also because of its psychological effects.
Gender, age, wound depth, size of a wound, and genetic makeup are some key factors that determine the likelihood of developing HS.
According to the new paper, hypertrophic scarring is an issue in between 40 and 94 percent of patients after surgery. About 30-91 percent of patients have it in the aftermath of a burn injury.
The researchers disclosed that HS incidence is even higher in developing countries.
Experts agree that the length of time it takes for a wound to heal is a major factor in the development of HS. The less time it takes to heal, the lower the likelihood of thorny skin scarring.
Around a third of wounds resulted in HS when healing took place within 14-21 days, the researchers said. However, the incidence was almost 80 percent when healing took longer.
Strategies for Prevention of Hypertrophic Scars
Current treatments for this skin condition are mostly invasive. It depends mainly on simple surgical excision.
Researchers set out to find ways to prevent HS from forming at all in the recent paper. They were interested mainly in treatments that were not surgical.
The team found that pressure therapy, a popular non-invasive treatment for skin scarring, could help greatly. However, the proven remedy appeared to help most when performed within two months of suffering an injury.
According to the paper, topical steroids can be beneficial to patients with burn injuries. The compounds help to inhibit chronic inflammation that could lead to skin scarring.
The use of ablative fractional lasers in dealing with scars is becoming more popular. Evidence showed that laser treatment can prevent HS formation when done early. However, the scientists noted that further research is vital to better understand how this treatment prevents HS from forming.
The popular aesthetic drug Botox, specifically botulinum toxin A (btxA), was also promising. But the researchers who prepared this paper suggested a need to first determine the ideal drug strength to use.
The paper nonetheless proposes resection and radiation as possibly useful secondary treatments in some cases. Surgical excision with postoperative radiation within the first two days of an injury helps to prevent larger scars, which are common with a regular procedure. Radiation therapy reduces inflammation and regulates the production of fibroblasts.
The scientists, however, indicated the need for long-term results to verify the reliability of resection or radiation as an adjunct for HS.
In addition, the paper also draws attention to some treatments that could help manage HS effectively in the future. These include anti-inflammatory therapy, anti-angiogenesis therapy, and adipose-derived cell therapy.
Strategies to prevent hypertrophic scar formation: a review of therapeutic interventions based on molecular evidence. Shirakami et al. Burns & Trauma, 27 January 2020. (https://academic.oup.com/burnstrauma/article/8/1/tkz003/5706922)