Scar Management in Pediatric Patients

<i>Background and Objectives</i>: Pediatric patients can acquire scars from both accidental injury and surgical procedures. While scars cannot be avoided if a full-thickness injury occurs, scar visibility may be minimized through a variety of approaches. In this narrative review, we eval...

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Main Authors: Sydney Barone, Eric Bao, Stephanie Rothberg, Jose F. Palacios, Isabelle T. Smith, Neil Tanna, Nicholas Bastidas
Format: Article
Language:English
Published: MDPI AG 2025-03-01
Series:Medicina
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Online Access:https://www.mdpi.com/1648-9144/61/4/553
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author Sydney Barone
Eric Bao
Stephanie Rothberg
Jose F. Palacios
Isabelle T. Smith
Neil Tanna
Nicholas Bastidas
author_facet Sydney Barone
Eric Bao
Stephanie Rothberg
Jose F. Palacios
Isabelle T. Smith
Neil Tanna
Nicholas Bastidas
author_sort Sydney Barone
collection DOAJ
description <i>Background and Objectives</i>: Pediatric patients can acquire scars from both accidental injury and surgical procedures. While scars cannot be avoided if a full-thickness injury occurs, scar visibility may be minimized through a variety of approaches. In this narrative review, we evaluate the current evidence and propose an algorithm for scar management in pediatric patients. <i>Materials and Methods</i>: A review of the literature was performed for scar management techniques for pediatric patients. Management modalities based on the type of scar and dosing, treatment regimen, and safety profiles are described in this article and used to create a scar management algorithm. <i>Results</i>: The initial step to scar management in the pediatric population involves ensuring minimal wound tension, which can be achieved through making the incision along relaxed skin tension lines, and early, minimal tension wound closure. Subsequent treatments to optimize scar care should begin 2–3 weeks following wound closure and involve the application of silicone gel or sheets and scar massaging. When topical products are insufficient, laser therapy can be utilized for the management of immature erythematous or thick scars. When mature, pathological scars form such as atrophic scars, hyperpigmentation, hypertrophic scars, or keloids, a combination of modalities is recommended. These modalities vary by scar type and include retinoids and dermabrasion for atrophic scars; retinoids, hydroquinone, and laser therapy for hyperpigmentation; and pressure therapy, corticosteroids, and laser therapy for hypertrophic scars and keloids. When mature, pathological scars persist following 12 months of non-invasive therapies, surgical excision should be considered. <i>Conclusions</i>: Several treatment options are available to manage scars in the pediatric population depending on scar type.
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spelling doaj-art-59e18638e70d447fba66c161468c812e2025-08-20T02:28:24ZengMDPI AGMedicina1010-660X1648-91442025-03-0161455310.3390/medicina61040553Scar Management in Pediatric PatientsSydney Barone0Eric Bao1Stephanie Rothberg2Jose F. Palacios3Isabelle T. Smith4Neil Tanna5Nicholas Bastidas6Division of Plastic and Reconstructive Surgery, Lewis Katz School of Medicine, Temple University, Philadelphia, PA 19140, USADivision of Plastic and Reconstructive Surgery, Northwell Health, New York, NY 10022, USADivision of Plastic and Reconstructive Surgery, Donald & Barbara Zucker School of Medicine, Hofstra University/Northwell, Hempstead, NY 11549, USADivision of Plastic and Reconstructive Surgery, Northwell Health, New York, NY 10022, USADivision of Plastic and Reconstructive Surgery, Northwell Health, New York, NY 10022, USADivision of Plastic and Reconstructive Surgery, Northwell Health, New York, NY 10022, USADivision of Plastic and Reconstructive Surgery, Northwell Health, New York, NY 10022, USA<i>Background and Objectives</i>: Pediatric patients can acquire scars from both accidental injury and surgical procedures. While scars cannot be avoided if a full-thickness injury occurs, scar visibility may be minimized through a variety of approaches. In this narrative review, we evaluate the current evidence and propose an algorithm for scar management in pediatric patients. <i>Materials and Methods</i>: A review of the literature was performed for scar management techniques for pediatric patients. Management modalities based on the type of scar and dosing, treatment regimen, and safety profiles are described in this article and used to create a scar management algorithm. <i>Results</i>: The initial step to scar management in the pediatric population involves ensuring minimal wound tension, which can be achieved through making the incision along relaxed skin tension lines, and early, minimal tension wound closure. Subsequent treatments to optimize scar care should begin 2–3 weeks following wound closure and involve the application of silicone gel or sheets and scar massaging. When topical products are insufficient, laser therapy can be utilized for the management of immature erythematous or thick scars. When mature, pathological scars form such as atrophic scars, hyperpigmentation, hypertrophic scars, or keloids, a combination of modalities is recommended. These modalities vary by scar type and include retinoids and dermabrasion for atrophic scars; retinoids, hydroquinone, and laser therapy for hyperpigmentation; and pressure therapy, corticosteroids, and laser therapy for hypertrophic scars and keloids. When mature, pathological scars persist following 12 months of non-invasive therapies, surgical excision should be considered. <i>Conclusions</i>: Several treatment options are available to manage scars in the pediatric population depending on scar type.https://www.mdpi.com/1648-9144/61/4/553pediatricspediatric scarsscarsscar management
spellingShingle Sydney Barone
Eric Bao
Stephanie Rothberg
Jose F. Palacios
Isabelle T. Smith
Neil Tanna
Nicholas Bastidas
Scar Management in Pediatric Patients
Medicina
pediatrics
pediatric scars
scars
scar management
title Scar Management in Pediatric Patients
title_full Scar Management in Pediatric Patients
title_fullStr Scar Management in Pediatric Patients
title_full_unstemmed Scar Management in Pediatric Patients
title_short Scar Management in Pediatric Patients
title_sort scar management in pediatric patients
topic pediatrics
pediatric scars
scars
scar management
url https://www.mdpi.com/1648-9144/61/4/553
work_keys_str_mv AT sydneybarone scarmanagementinpediatricpatients
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AT josefpalacios scarmanagementinpediatricpatients
AT isabelletsmith scarmanagementinpediatricpatients
AT neiltanna scarmanagementinpediatricpatients
AT nicholasbastidas scarmanagementinpediatricpatients