Recent Advances in Scar Research and Unanswered Questions

Hypertrophic scars or keloids are aesthetically disfiguring and can cause pain, itching, discomfort as well as psychological stress, often significantly impairing the patients’ quality of life. The mechanisms that initiate hypertrophic scarring are incompletely understood, which is why these scars remain a challenging problem for patients, clinicians, and researchers. With recent advances in molecular biology and genetics, insight is being gained on the complex process of scar formation and therapeutic options are constantly evolving. However, no absolutely satisfactory or optimal treatment modality of all keloid subtypes has been defined yet. To investigate the pathophysiology of hypertrophic scarring and develop optimal treatment modalities, adequate in vitro and in vivo scar models are essential. However, existing models are limited in several ways, challenging researchers aiming at prevention and effective therapeutic intervention. The development of improved models and carefully designed preclinical studies involving cells and tissues isolated from keloid scars is of utmost importance to push the field forwards. This chapter discusses the complexities of modeling hypertrophic scarring, summarizes currently available models in scar research, and describes new technologies that may improve future models. Furthermore, emerging treatment modalities for hypertrophic scars will be discussed.