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Keloids and Hypertrophic Scars: A Spectrum of Clinical Challenges

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Abstract

Since their earliest description, keloids and hypertrophic scars have beleaguered patients and clinicians alike. These scars can be aesthetically disfiguring, functionally debilitating, emotionally distressing, and psychologically damaging, culminating in a significant burden for patients. Our current understanding of keloid pathophysiology has grown and continues to advance while molecular biology, genetics, and technology provide ever-deepening insight into the nature of wound healing and the pathologic perturbations thereof. Greater understanding will lead to the development and application of refined therapeutic modalities. This article provides an overview of our current understanding of keloids, highlighting clinical characteristics and diagnostic criteria while providing a comprehensive summary of the many therapeutic modalities available. The proposed mechanism, application, adverse events, and reported efficacy of each modality is evaluated, and current recommendations are summarized.

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Acknowledgments

The authors would like to thank Antoinette F. Hood, MD, for the histopathology slides and Donald Glass, MD, for the clinical pictures of keloids. The authors would also like to acknowledge Meena Katdare, PhD, for her guidance throughout the writing process.

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    1. Department of Radiology, Eastern Virginia Medical School, Norfolk, VA, USA

      Anthony P. Trace

    2. The School of Medicine, Eastern Virginia Medical School, Norfolk, VA, USA

      Clinton W. Enos

    3. Hampton University Skin of Color Research Institute, Hampton University, Hampton, VA, USA

      Alon Mantel & Valerie M. Harvey

    4. Department of Dermatology, Eastern Virginia Medical School, 721 Fairfax Ave., Norfolk, VA, 23507, USA

      Valerie M. Harvey

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    A. P. Trace and C. W. Enos contributed equally in the generation of this manuscript.

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    Trace, A.P., Enos, C.W., Mantel, A. et al. Keloids and Hypertrophic Scars: A Spectrum of Clinical Challenges. Am J Clin Dermatol 17, 201–223 (2016). https://doi.org/10.1007/s40257-016-0175-7

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