Scars

• Published in: Nature reviews. Disease primers 2023-11, Vol.9 (1), p.64-64, Article 64
• Main Authors: Jeschke, Marc G., Wood, Fiona M., Middelkoop, Esther, Bayat, Ardeshir, Teot, Luc, Ogawa, Rei, Gauglitz, Gerd G.
• Format: Article
• Language: English
• Subjects: 692/1807/1812; 692/699/4033; Cancer Research; Epidemiology; Internal Medicine; Medical Microbiology; Medicine; Medicine & Public Health; Primer; Quality of Life Research; Scars; Wound healing
• ISSN: 2056-676X; 2056-676X
• DOI: 10.1038/s41572-023-00474-x

Wound healing occurs as a response to disruption of the epidermis and dermis. It is an intricate and well-orchestrated response with the goal to restore skin integrity and function. However, in hundreds of millions of patients, skin wound healing results in abnormal scarring, including keloid lesions or hypertrophic scarring. Although the underlying mechanisms of hypertrophic scars and keloid lesions are not well defined, evidence suggests that the changes in the extracellular matrix are perpetuated by ongoing inflammation in susceptible individuals, resulting in a fibrotic phenotype. The lesions then become established, with ongoing deposition of excess disordered collagen. Not only can abnormal scarring be debilitating and painful, it can also cause functional impairment and profound changes in appearance, thereby substantially affecting patients’ lives. Despite the vast demand on patient health and the medical society, very little progress has been made in the care of patients with abnormal scarring. To improve the outcome of pathological scarring, standardized and innovative approaches are required. Every injury of the skin undergoes a process known as wound healing. When wound healing is disrupted, excessive scars, such as hypertrophic scars and keloid lesions, can develop. This Primer summarizes the epidemiology, mechanisms, diagnosis and treatment of scars, as well as discussing how scars can affect an individual’s quality of life.