Scar dressings are commonly used in managing burn and hypertrophic scars, although supporting evidence is lacking. Care providers commonly report improvements, however, and pressure therapy has been effective in treating ear keloids. The general acceptance of the treatment as effective may prevent it from being further studied in clinical trials. A long-term course of corticosteroid injections into the scar may help flatten and soften the appearance of keloid or hypertrophic scars. Topical steroids are ineffective. However, clobetasol propionate can be used as an alternative treatment for keloid scars. Scar revision is a process of cutting the scar tissue out. After the
Granulation tissue cell types, most of which can be associated with one of the following functions: An excess of granulation tissue ("caro luxurians") is informally referred to as "proud flesh." The extracellular matrix of granulation tissue is created and modified by fibroblasts. Initially, it consists of a network of type-III collagen, a weaker form of the structural protein that can be produced rapidly. This is later replaced by the stronger, long-stranded type-I collagen, as evidenced in scar tissue. The main immune cells active in the tissue are macrophages and neutrophils, although other leukocytes are also present. These work to phagocytize old or