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A Combination Approach to Surgical Scars

Eilers, Robert E. Jr MD; Ross, Edward Victor MD; Cohen, Joel L. MD; Ortiz, Arisa E. MD

doi: 10.1097/DSS.0000000000000750
Review Article

BACKGROUND Scar formation from surgical procedures is an unavoidable risk. Despite measures taken by both the surgeon and patient during the perioperative and postoperative periods to maximize cosmesis, some patients will wish to pursue surgical or laser scar revision.

OBJECTIVE The authors propose a treatment algorithm to assist in approaching surgical scar revision with combination treatments.

MATERIALS AND METHODS A PubMed search was performed on various surgical scar revision techniques. The authors augment these findings with their own personal experiences.

RESULTS Reports of surgical excision, intralesional corticosteroid injection, intralesional 5-fluorouracil injection, pulse dye laser treatment, nonablative fractional laser resurfacing, ablative fractional laser resurfacing, and microneedling and fractional needle radiofrequency, used in isolation or combination, were found. The authors also provide clinical photographs documenting improvement in appearance of surgical scars using these treatments.

CONCLUSION Surgical scars are best treated with a combination approach to address various features of the scar. The authors propose a treatment algorithm with multiple treatment options and how to combine them safely and effectively.

*Department of Dermatology, University of California San Diego, San Diego, California;

Scripps Clinic, Laser and Cosmetic Dermatology, San Diego, California;

Department of Dermatology, University of Colorado, Boulder, Colorado

Address correspondence and reprint requests to: Arisa E. Ortiz, MD, Department of Dermatology, University of California San Diego, 8899 University Center Lane, Suite 350, San Diego, CA 92122, or e-mail:

The authors have indicated no significant interest with commercial supporters in regards to this work.

© 2016 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.
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