Scar Management: Keloid, Hypertrophic, Atrophic, and Acne Scars

THE WOUND REPARATIVE process results in a spectrum of scar formation ranging from nearly scarless healing to excessive fibrosis or atrophy. Scars can be divided into two basic categories: (1) keloidal and hypertrophic scars and (2) atrophic scars. A third scar type–a fiat scar–is characterized by what is considered the normal healing process. The options for treating fiat scars are numerous, frequently involving surgical revision. This is often not sought, as the fiat scar in most cases becomes imperceptible with time. However, when the wound healing process produces a raised or atrophic scar, management can be modified and improvements made to the appearance of the scar through a variety of techniques. Treatment of these scars is driven in large part by the underlying anatomy and the cause of the defect.

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