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<p>Scars represent a&#xa0;common dermatological condition with significant functional, esthetic, and psychosocial impact, requiring a&#xa0;differentiated therapeutic approach. In general, scars are classified as atrophic, hypertrophic, or keloid. Recent studies indicate that particularly in hypertrophic scars and keloids, early therapeutic intervention and multimodal treatment approaches lead to the most favorable outcomes. Established first-line therapies include silicone gels or silicone sheets as well as intralesional corticosteroid injections with triamcinolone acetonide. Combination therapies, such as triamcinolone acetonide combined with 5‑fluorouracil or triamcinolone acetonide combined with hyaluronidase, have demonstrated superior efficacy and lower recurrence rates compared with monotherapy. Laser-based procedures constitute an important component of modern scar management. In particular, ablative fractional CO<sub>2</sub> and Er:YAG lasers have shown high efficacy in the treatment of atrophic scars, while vascular lasers can also be used for hypertrophic scars. In addition, minimally invasive procedures such as microneedling have gained increasing attention. When combined with platelet-rich plasma (PRP), regenerative processes may be further enhanced.</p><p>Another innovative approach is laser-assisted drug delivery, improving the penetration of topical medications. Newer laser systems such as thulium and difference-frequency generation (DFG) lasers have demonstrated promising results in this context.</p><p>A&#xa0;multimodal approach is also recommended for the management of hyperpigmentation and melasma. The cornerstone of therapy is strict broad-spectrum photoprotection against both ultraviolet and visible light. The gold standard for initial treatment remains a&#xa0;hydroquinone-based triple combination, although it should only be used for a&#xa0;limited period to minimize adverse effects. Procedural therapies, such as chemical peels, microneedling, and laser devices, are reserved for refractory cases and should be performed by experienced clinicians due to risk of adverse effects and postinflammatory hyperpigmentation.</p>

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Fortschritte in der ästhetischen Dermatologie

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月14日

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  • Julia Valencak

摘要

Scars represent a common dermatological condition with significant functional, esthetic, and psychosocial impact, requiring a differentiated therapeutic approach. In general, scars are classified as atrophic, hypertrophic, or keloid. Recent studies indicate that particularly in hypertrophic scars and keloids, early therapeutic intervention and multimodal treatment approaches lead to the most favorable outcomes. Established first-line therapies include silicone gels or silicone sheets as well as intralesional corticosteroid injections with triamcinolone acetonide. Combination therapies, such as triamcinolone acetonide combined with 5‑fluorouracil or triamcinolone acetonide combined with hyaluronidase, have demonstrated superior efficacy and lower recurrence rates compared with monotherapy. Laser-based procedures constitute an important component of modern scar management. In particular, ablative fractional CO2 and Er:YAG lasers have shown high efficacy in the treatment of atrophic scars, while vascular lasers can also be used for hypertrophic scars. In addition, minimally invasive procedures such as microneedling have gained increasing attention. When combined with platelet-rich plasma (PRP), regenerative processes may be further enhanced.

Another innovative approach is laser-assisted drug delivery, improving the penetration of topical medications. Newer laser systems such as thulium and difference-frequency generation (DFG) lasers have demonstrated promising results in this context.

A multimodal approach is also recommended for the management of hyperpigmentation and melasma. The cornerstone of therapy is strict broad-spectrum photoprotection against both ultraviolet and visible light. The gold standard for initial treatment remains a hydroquinone-based triple combination, although it should only be used for a limited period to minimize adverse effects. Procedural therapies, such as chemical peels, microneedling, and laser devices, are reserved for refractory cases and should be performed by experienced clinicians due to risk of adverse effects and postinflammatory hyperpigmentation.