Is there a consensus for scar treatment?

Scarring and its accompanying esthetic, functional, and psychological sequelae still pose major challenges. To date, there is no satisfactory prevention or treatment option for hyper trophic scars on the tops of toes, which is mostly due to not completely comprehending the mechanisms underlying their formation. However, providing footwear advice is the most logical prevention option but this may not balance with the individuals needs and desires. 

A predominant role in hypertrophic scarring prevention and treatment still remains silicone sheeting or gel. The efficacy and safety of this gold-standard, non-invasive therapy has been demonstrated in many clinical studies, but to date, exact mechanisms by which they improve hyper trophic scars are yet to be fully agreed upon.

Second most validated and more specialised scar treatment is intralesional corticosteroid injections, especially in combination with other therapeutic modalities.

Current therapeutic approaches with their empirical effects are unreliable and unpredictable. Therefore, there is an unmet need for an effective, targeted therapy and prevention, which would be based on an action or a modulation of a specific factor with clarified mechanism of action that has a beneficial effect on wound healing. As the extra cellular matrix is involved in cellular and extracellular events that lead to pathological scarring, targeting its components mostly by regulating bone morphogenetic proteins may shed light on a new therapeutic approach for reduction or prevention of pathological scarring or hyper trophic scars with functionally and cosmetically acceptable outcome.