ABSTRACT
This chapter reviews the topical and intralesional treatments available for scar modulation. Intralesional corticosteroids are commonly used in the management of hypertrophic scars. A study using three-dimensional imaging to calculate the volume of keloids and to measure their response to intralesional steroids found that the majority of patients had greater than 50% improvement within 8 weeks of starting therapy. The adverse effects of intralesionally injected bleomycin are much less extensive and severe than those of systemic bleomycin, with the main ones being hyperpigmentation and dermal atrophy. The chapter examines the evidence for and against some commonly used agents and presents several emerging therapies. Numerous topical and injectable therapies exist for the treatment of postsurgical scars. In a study comparing the efficacy of intralesional corticosteroids, 5-Fluorouracil, and combined therapy for the treatment of hypertrophic scars, the average onset of action was found to be similar for all three therapeutic modalities.
