A critical appraisal of nonsurgical modalities for managing hypertrophic scars and keloids

SummaryThe nature of hypertrophic scars and keloids can be unpredictable even to the most experienced physicians. Predicting the susceptibility and severity of these disorders is difficult. The availability of numerous treatment options which yield various results make deciding on a course of treatment difficult. Further complicating the selection of treatment options are the numerous industry-driven publications that seem biased and are supported by marketing strategies for related products. Physicians often end up using a treatment modality that is not particularly objective or supported by a high level of evidence. Reviewing literature on this topic can be daunting. This study attempts to clarify the complex fibroproliferative disorder of skin wound healing by briefly describing its pathophysiology, categorizing patients into distinct groups based on their clinical behavior, and analyzing relevant evidence for each treatment modality.