What are treatment options for keloids and hypertrophic scars?

Updated: May 29, 2020
  • Author: Brian Berman, MD, PhD; Chief Editor: Dirk M Elston, MD  more...
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Prevention is key, but therapeutic treatment of an existing hypertrophic scar or keloid includes occlusive dressings, compression therapy, intralesional corticosteroid injections, cryosurgery, excision, radiation therapy, laser therapy, interferon (IFN) therapy, 5-fluorouracil (5-FU), doxorubicin, bleomycin, verapamil, retinoic acid, imiquimod 5% cream, tamoxifen, tacrolimus, botulinum toxin, hydrogel scaffold, and over-the-counter treatments (eg, onion extract; combination of hydrocortisone, silicon, and vitamin E). These therapies have been used to reduce the rate of keloid recurrence after surgical excision, with superficial radiation therapy being the most effective.

Other promising potential therapies include antiangiogenic factors, including vascular endothelial growth factor (VEGF) inhibitors (eg, bevacizumab), phototherapy (photodynamic therapy [PDT], UVA-1 therapy, narrowband UVB therapy), ingenol mebutate gel, transforming growth factor (TGF)–beta inhibitors, tumor necrosis factor (TNF)–alpha inhibitors (etanercept), recombinant human epidermal growth factor (rhEGF), recombinant human interleukin (rhIL)–10, small interfering RNA and oligonucleotide anti‒connective-tissue growth factor, and mimic micro RNA29.

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