Severe scarring is known for causing severe functional, aesthetic, and psychosocial impairments. During the last years, treatment of mature scars has evolved significantly; however, researchers and clinicians are more and more focused on preventing excessive scarring altogether, thus avoiding long and strenuous treatment. While some forms of scar prevention have been known and used for decades, others are relatively new and have yet to prove themselves. Pressure garments have long been successfully used in widespread burn scar prevention. However, reduced compliance, large treatment costs, and little hard evidence are points that should be taken into consideration regarding this well-established form of treatment. Silicone gel sheeting has also been used for a long time, and it is well regarded for its efficacy in reducing scar height and improving pliability while boasting little side effects. Its mode of action, however, remains unclear. Recently, lasers have become a new focus in the effort to prevent pathological scarring. Here, the older pulsed dye laser, as well as newer, fractional ablative and nonablative lasers, is increasingly employed for the treatment of fresh scars, where initial research is showing significant promise.
This chapter explores the currently available methods for scar prevention and examines their application and the evidence regarding their efficacy.
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