Pirfenidone in Skin Fibrosis and Scarring: From Bench Insights to Clinical Data.

Pirfenidone (PFD) is a pyridine-like compound most well-known for its use in idiopathic pulmonary fibrosis (IPF). However, its broad anti-inflammatory and anti-fibrotic actions make PFD a candidate for other scarring diseases. This review examines the use of PFD for dermatologic conditions. The literature supports the potential for PFD to decrease scarring in a variety of skin conditions. Both oral and topical preparations have been shown to be effective at aiding skin healing. Early clinical evidence demonstrates significant improvements in hypertrophic burn scars, reduction in fibrosis in localized scleroderma, and accelerated epithelialization of skin graft donor sites. These clinical outcomes are supported by PFD's modulation of the transforming growth factor-beta (TGF-β) pathway, which plays a central role in skin fibrosis and scarring. Evidence in this review suggests topical PFD can be used to fill a clinical need for local anti-fibrotic therapies.