Brachytherapy has been used. In general, radiation therapy is used as a second or third line treatment modality. Pressure Dressings Multiple mechanisms of action proposed. Patient compliance is crucial. Silicone Gel Sheeting Mechanism of action through scar hydration, postulated that hydration via decreased evaporation results in decreased capillary action thus decreased collagen production secondary to decrease in cytokine delivery.
Silicone has no direct action.
Laser Surgery Pulsed dye laser seems to be effective in the treatment of both types of scars. Probable mechanism is through elimination of neovascularization. Other laser systems seem to have increased risks. Can be utilized in a combination treatment with corticosteroids. Corticosteroids Mechanism of action through inhibition of fibroblast growth and inhibiting a 2 -macroglobulin, resulting in collagen degradation.