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Laser therapy for hypertrophic scars and keloids

Authors
C Scott Hultman, MD, MBA, FACS
Shunsuke Yoshida, MD, MS
Section Editors
Robert P Dellavalle, MD, PhD, MSPH
Moise L Levy, MD
Deputy Editor
Rosamaria Corona, MD, DSc

INTRODUCTION

Hypertrophic scars and keloids are cutaneous lesions resulting from an excessive tissue response to dermal injury (eg, surgical procedures, trauma, burns, inflammatory skin conditions) and characterized by local fibroblast proliferation and overproduction of abnormal collagen. The clinical features and classification of hypertrophic scars and keloids are summarized in the table (table 1).

Hypertrophic scars present as raised lesions with varying degree of erythema depending upon the maturation stage that typically do not exceed the margins of the original wound. They usually develop two to six months after the initial insult and show a tendency to regress at 18 to 24 months following injury [1]. Associated symptoms include pain, pruritus, and functional limitations. Keloids can occur months or years after injury, extend beyond the limits of the initial injury, and show no tendency to regress.

Many treatments have been tried, with limited success, to reduce the symptoms associated with abnormal scarring, such as redness, pain, pruritus, or functional limitations, and to improve the clinical appearance. These treatments range from minimally invasive interventions (eg, massage, moisturizing agents, pressure garments, silicone sheeting) to topical or intralesional corticosteroids, surgical excision with various reconstructive techniques, or radiation therapy [2,3]. Unfortunately, recurrence rates are high, and multiple or combination therapies are often required to reduce the scar volume and achieve functional and/or cosmetic improvement.

Laser therapy is a relatively new treatment modality for keloids and hypertrophic scars. In particular, the utilization of specific laser platforms has emerged as a successful strategy in the treatment of symptomatic hypertrophic scars following burn injury.

This topic will discuss the available modes of laser therapy for the treatment of hypertrophic scars and keloids, with a focus on treatment of hypertrophic burn scars. Other treatment modalities for hypertrophic scars and keloids are discussed separately. The principles of laser therapy and the use of laser for the treatment of other skin conditions are also discussed separately.

                         

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Literature review current through: Nov 2016. | This topic last updated: Wed Nov 25 00:00:00 GMT+00:00 2015.
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