CC BY-NC-ND 4.0 · Arch Plast Surg 2023; 50(01): 118
DOI: 10.1055/s-0042-1758642
Letter to the Editor

Response to Letter: Comments on Management of Keloid Scars: Noninvasive and Invasive Treatments

1   Department of Plastic and Reconstructive Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
› Author Affiliations

Keloid scars can cause not only physical and aesthetic impairment but also psychosocial sequelae, which can further impair quality of life.[1] [2] They show significant pain, persistent itching, stiffness, and scar contracture.[1] [2] In addition, they can have psychological effects, including diminished self-esteem, disruption of daily life, anxiety, and depression.[1] [2] [3]

Currently, various treatment options for the treatment of keloid scars have been introduced. Nevertheless, the scars cannot be eradicated completely and the treatment of scars often takes several months.[4] Physical symptoms, such as pain, itching, stiffness, and contracture, are targeted for aggressive treatment, but there is no guidance on psychological factors.[4] Besides, the psychosocial impact of scars is hard to standardize as individual response to scars is not generalizable.[3] [5]

This deficiency of management of psychological factors might be due to inadequate training, insufficient clinical experiences, or lack of awareness of their responsibility.[4]

Multidisciplinary approach is required in the recognition and management of psychosocial effects associated with scars. Multidisciplinary team should include experts including dermatologists, plastic surgeons, general surgeons, medical, rehabilitation and burn specialists, psychosocial and behavioral researchers, epidemiologists, and beauticians.[1]

The treatment should start before scarring in inpatient and outpatient setting to explain to patients what scars are, why they form, how to prevent and treat them, and how to manage potential psychosocial effects.[5]

Within this multidisciplinary approach, plastic surgeons should be aware of that it is our role to overall manage the keloid scars and overall patient quality of like.



Publication History

Received: 06 October 2022

Accepted: 07 October 2022

Article published online:
06 February 2023

© 2023. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Kim SW. Management of keloid scars: noninvasive and invasive treatments. Arch Plast Surg 2021; 48 (02) 149-157
  • 2 Bell L, McAdams T, Morgan R. et al. Pruritus in burns: a descriptive study. J Burn Care Rehabil 1988; 9 (03) 305-308
  • 3 Bakker A, Maertens KJ, Van Son MJ, Van Loey NE. Psychological consequences of pediatric burns from a child and family perspective: a review of the empirical literature. Clin Psychol Rev 2013; 33 (03) 361-371
  • 4 Ngaage M, Agius M. The psychology of scars: a mini-review. Psychiatr Danub 2018; 30 (Suppl. 07) 633-638
  • 5 Tredget EE, Shupp JW, Schneider JC. Scar management following burn injury. J Burn Care Res 2017; 38 (03) 146-147