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
Scar free healing significant clinical burden which is why the scar free healing concept is of interest. Some of the problems in scar healing lie in the physical outcome of the process: for example when collagen is abnormally organised in scar tissue. In scars the collagen is arranged in parallel bundles of the collagen fibres whilst healthy scar free tissue has a "basket weave" structure (Figure 1). The difference in collagen arrangement along with a lack of difference in the dermal tissue when healing has taken place with or without scarring is indicative of regenerative failure of normal skin. Severe scarring resulting from