Therapy of pathological scars


  • Justinus A. Wagner

    Corresponding author
    1. Department of Dermatology, Venereology and Allergology, Leipzig University Hospital, Germany
    • Correspondence to

      Dr. med. Justinus A. Wagner

      Klinik für Dermatologie, Venerologie und Allergologie

      Universitätsklinikum Leipzig A.ö.R.

      Philipp-Rosenthal-Straße 23

      04103 Leipzig, Germany


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  • Section Editor Prof. Dr. Jan C. Simon, Leipzig

  • 58.6 million Germans have scars – 10.6 million wish they did not have them.

  • It is impossible, after the fetal stage, to restore the skin to its original condition.

  • Wound healing depends on many endogenous and exogenous factors.

  • Keloids are lesions in which the scar tissue grows beyond the wound bed.

  • Unlike keloids, hypertrophic scars can also resolve spontaneously.

  • Distinguishing them clinically is sometimes difficult.

  • Scars with contour problems are often perceived as cosmetically disturbing by patients.

  • Before treating any scar, the scar type should be diagnosed.

  • In addition to subjective parameters and systems, scars may also be measured objectively.

  • Given that each individual scar is different, it is impossible to make recommendations for a standard therapy.

  • In most instances, combination therapy is advisable.

  • Surgical planning with diverse surgical techniques is paramount for good healing of the scar.

  • Along with reducing symptoms, the goal of scar treatment is to minimize volume and color.

  • In surgical correction of pathological scars as monotherapy, depending on the type of scar, a higher rate of recurrence may be expected.


The various clinical manifestations of scarring are an important topic for physicians in many disciplines. The prevention of excessive scarring is more successful than the treatment afterwards. Multiple options exist for prevention, wound repair modulation, and treatment of scars. This publication includes an overview of the pathogenesis, clinical classification, documentation, prevention, and invasive and non-invasive therapy options.