Why don't we have more effective treatment for keloids?

Numerous treatment modalities have been used to treat keloids and hypertrophic scars, but optimal treatment has not yet been established. The failure of achieving better therapeutic results in treating keloids highlights the essential problem that the pathogenetic mechanisms causing keloids remain unclear. Increased understanding at the molecular level will lead to the development of new therapies. Prevention is the first rule in keloid therapy. Conventional and experimental therapeutic approaches are presented in this review but further investigation is needed in relation to safety, adverse effects, and therapeutic efficacy. Because of the high recurrence rate of keloid scars, a follow-up period of at least 1 year is required to enable the start of treatment of recurrences as expediently as possible and to evaluate long-term success.