| Diagnosis | Therapy |
| First-line | Second-line | Third-line | Management after favorable treatment response |
| Fresh burn scar (preventive measures) |
| | - Silicone gel/sheet or onion extract formulations
- Begin two weeks after injury (eg, in combination with pressure therapy)
- Continue for three months
| - Pulsed-dye laser (PDL) therapy for persisting erythema
| | |
| Immature scar, erythematous hypertrophic scar, minor keloid |
| | - Triamcinolone acetonide (TAC) injections
- Men 20 to 40 mg/mL
- Women 10 to 40 mg/mL
- Use in combination with silicone gel or sheet
- Intralesional corticosteroidal injection with silicone gel or sheeting
| - Cryotherapy (10 to 15 seconds)
- Directly followed by TAC injections until scar has flattened over time
| - 5- fluorouracil (5-FU; topical) with TAC injections
- Administer every other week
Or: - Intralesional cryotherapy
- Ultimo ratio excision and appropriate prophylactic therapy (NTA)
| |
| Widespread hypertrophic burn scar |
| Tension present | - Surgical release
- Z-plasty
- W-plasty
- Excision and reconstructive flaps
| | | |
| No tension present | - Silicone gel preparations
- Compression therapy
- Onion extract formulations
| - Individual counseling
- Ablative fractional laser
| | |
| Major keloid |
| | - Cryotherapy (10 to 15 seconds)
- Directly followed by TAC injections until scar has flattened
| - Combination every other week of
- Intralesional cryotherapy
| - Combination of
- Surgical excision
- Radiation therapy
- TAC
| |
