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Hypertrophic scarring and keloids following burn injuries

Gerd G Gauglitz, MMS, MD
Section Editor
Marc G Jeschke, MD, PhD
Deputy Editor
Kathryn A Collins, MD, PhD, FACS


Keloids and hypertrophic scars are aberrations of physiologic wound healing characterized by greater and more sustained extracellular matrix deposition. They may also develop following any insult to the dermis.

The early application of topical therapies is advocated for healed burns in an effort to prevent hypertrophic scarring, particularly for deep burn injuries or those that show signs of delayed healing. The role of pressure garment therapy is less clear.

Keloids and hypertrophic scars affect the patient's quality of life, both physically and psychologically, causing pain, pruritus, and contractures. As such, burn patients should be promptly referred to a surgeon experienced in burn care if the wound fails to begin reepithelialization by two weeks, or at the first sign of hypertrophic scarring.

The evaluation and treatment of keloids and hypertrophic scars that result from burn injury is reviewed here. The initial management of the burn wound is reviewed separately. (See "Overview of the management of the severely burned patient".)


Hypertrophic scars occur in between 30 and 90 percent of patients following burns [1,2].

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Literature review current through: Nov 2017. | This topic last updated: Nov 17, 2017.
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