Minimal-Invasive Technologies for Treatment of HTS and Keloids: Corticosteroids

Abstract

Hypertrophic scars and keloids are common lesions caused by abnormal wound healing process. Especially in keloids, abnormal fibroblast activity and excessive synthesis of collagen is a histopathological hallmark in its pathogenesis. Due to heterogeneity of etiologies and clinical presentations, treatment of hypertrophic scars and keloids are often challenging. The response rate varies widely, depending on treatment modalities and the timing of therapeutic intervention. Corticosteroid is considered to be one of the best treatment options, yet paucity of information exists on its mechanism of action. It is mostly known to inhibit abnormal fibroblast proliferation leading to collagen synthesis and promote further degeneration of extracellular matrix. Intralesional injection of corticosteroid has been well advocated in the treatment of both hypertrophic scars and keloids. Locally delivered corticosteroid causes significant decrease in scar volume and ameliorates the symptoms of the scars such as pain and pruritus. However, the lesions are prone to localized adverse reactions upon repeated treatments. Therefore, appropriate use of steroids requires awareness of its mechanism of action in scar treatment.