Emerging Therapies for Scar Prevention

Abstract

Significance: There are *12 million traumatic lacerations treated in the United States emergency rooms each year, 250 million surgical incisions created worldwide every year, and 11 million burns severe enough to warrant medical treatment worldwide. In the United States, over $20 billion dollars per year are spent on the treatment and management of scars. Recent Advances: Investigations into the management of scar therapies over the last decade have advanced our understanding related to the care of cutaneous scars. Scar treatment methods are presented including topical, intralesional, and mechanical therapies in addition to cryotherapy, radiotherapy, and laser therapy. Critical Issues: Current treatment options for scars have significant limitations. This review presents the current and emerging therapies available for scar management and the scientific evidence for scar management is discussed. Future Directions: Based upon our new understanding of scar formation, innovative scar therapies are being developed. Additional research on the basic science of scar formation will lead to additional advances and novel therapies for the treatment of cutaneous scars.

Neuronal Protein 3.1 Deficiency Leads to Reduced Cutaneous Scar Collagen Deposition and Tensile Strength due to Impaired Transforming Growth Factor-β1 to -β3 Translation

“…However, past and current antiscarring therapies have met limited success. 31 We indeed found that P311 production is switched on in healing wounds and normal and hypertrophic scars compared with normal skin, in which it is absent, indicating a potential role for P311 in scar formation. Indeed, in vivo and in vitro studies indicated that, because of its stimulation of TGF-b1 to -b3 translation, P311 is required for collagen deposition and tensile strength during normal scar formation which, in turn, is essential to prevent scar dehiscence.…”

Evaluating the Therapeutic Success of Keloids Treated With Cryotherapy and Intralesional Corticosteroids Using Noninvasive Objective Measures

“…Intralesional corticosteroid injections with supplementary cryotherapy are first-line therapy for the treatment of keloids. 2,39 In 1977, the combination of corticosteroids and cryosurgery was introduced and detailed information on the method provided. 36 Despite the lack of objective parameters, the promising results led to the establishment of this method.…”

Preventing Scars after Injury with Partial Irreversible Electroporation

“…However, therapy depth in skin is limited due to high scattering of light in skin, causing a fundamental impediment for this technology (Preissig et al 2012). Cryotherapy, historically limited to small scar volumes (Block et al 2015), improved in the recent years and up to 51% reduction of the scar size after a single treatment have been reported (Har-Shai et al 2008). Different types of radiotherapy, such as Brachytherapy, X-ray, and electron beam have been used for scar treatments; however, these technologies require special heavy equipment and need to be used carefully to avoid carcinogenesis (Block et al 2015).…”

“…Cryotherapy, historically limited to small scar volumes (Block et al 2015), improved in the recent years and up to 51% reduction of the scar size after a single treatment have been reported (Har-Shai et al 2008). Different types of radiotherapy, such as Brachytherapy, X-ray, and electron beam have been used for scar treatments; however, these technologies require special heavy equipment and need to be used carefully to avoid carcinogenesis (Block et al 2015). In contrast to the currently used physical therapies discussed above, for electroporation-based therapies, the distribution of the electric fields depends on the electrical properties of tissues such as resistance and capacitance (Golberg et al 2015a).…”