Clinical and Molecular Insights into Hypertrophic Scars and Keloids: A Literature Review

Background: Hypertrophic scars and keloids represent two distinct forms of abnormal wound healing, characterized by excessive fibrous tissue formation. Despite their prevalence, the pathophysiological mechanisms underlying their development and persistence remain incompletely understood. This literature review synthesizes current clinical and molecular insights into hypertrophic scars and keloids, aiming to highlight differences in their etiology, pathogenesis, and therapeutic responses. Methods: A comprehensive review of the literature was conducted, focusing on articles that provided significant insights into the clinical manifestations, genetic predispositions, molecular pathways, and treatment strategies related to hypertrophic scars and keloids. Experimental studies and clinical trials were included to encompass a wide range of data sources. Results: Hypertrophic scars are confined to the original wound boundary and may regress over time, whereas keloids extend beyond the wound margins and do not regress. Clinically, hypertrophic scars and keloids differ in their appearance, texture, and predilection sites. At the molecular level, these differences are underscored by distinct profiles of cytokine expression, growth factor activity, and extracellular matrix composition. Genetic studies have identified several predisposing factors, including specific gene mutations and polymorphisms. Treatment strategies vary; however, intralesional corticosteroids remain the first-line treatment for both conditions. Emerging therapies targeting specific molecular pathways offer potential for improved outcomes. Conclusion: Hypertrophic scars and keloids are complex conditions with distinct clinical and molecular characteristics. Understanding these differences is crucial for developing targeted and effective therapies. Future research should focus on unraveling the genetic basis of these conditions and exploring novel therapeutic targets. Enhanced knowledge of the pathogenic mechanisms will facilitate the advancement of personalized medicine approaches in the management of hypertrophic scars and keloids.