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. Author manuscript; available in PMC: 2015 Nov 1.
Published in final edited form as: Burns. 2014 Apr 24;40(7):1255–1266. doi: 10.1016/j.burns.2014.02.011

Table 4.

New updated recommendations for excessive scar management.

PREVENTION HTS Basic scar care Hydration/topical moisturizer
KELOID Massage
UV protection (sunscreen)
Non-concerned patient/low-cost measures Hypoallergenic microporous paper tape
Concerned patient SGS
TREATMENT HTS With contractures Surgery to release scar
Without contractures First line SGS 6 w and optional lasera
Second line TAC + optional cryotherapy combinedb
Third line Laserb (PDL or fractional laser therapy)
KELOID First line TAC + 5-FU + laser therapy + SGS
Second line Surgery + aforementioned conservative measures + optional additional brachytherapy

Note: These are just general recommendations. Each scar has to be studied in a case-by-case basis.

Abbreviations: HTS, hypertrophic scar; SGS, silicone gel sheeting; TAC, triamcinolone acetonide.

a

And/or pressure garments for 6–12 months, mainly in burn scars and other special cases; regarding laser, it was initially reserved as third-line therapy, but due to promising clinical results despite few scientific evidence, some consider to start with laser as well, which may help to enhance the efficacy of further treatments (such as TAC delivery). Cost-effectiveness studies should be performed first to confirm.

b

In the case of major burns and large scars, laser would be second line strategy, as TAC is usually scarcely used.