Management of Scars in Skin of Color

Abstract

Keloids and hypertrophic scars are abnormal scars, produced by an odd wound-healing response to trauma with a higher incidence in pigmented skin patients. They could be painful or itchy, producing functional and/or cosmetic disability. This chapter focuses on defining scars especially in pigmented skin and the different methods for treating keloids that have been investigated in the literature. Up to the present time, the ideal treatment method has not been defined, although numerous modalities have been designated. We will represent the variances among different scar types and their management methods, concentrating on their indications, modes of action, uses, safety, and efficiency of the following therapies: intralesional steroid, injections of silicone gel/sheet, radiotherapy, photodynamic therapy, electrical stimulation, surgical excision and adjuvant therapy, and cryosurgery. Combination therapies have also shown some value. Still, there is a shortage of randomized clinical trials (RCTs) evaluating such treatment modalities. Management of scar in pigmented (colored) skin is clinically challenging. Therefore, strategic assessment and targeted therapy with focus on deterring recurrence are most needed. The quality of evidence is crucial to select efficient treatments for patients with colored skin, presenting with keloid. Copyright 2020, The Author(s).