Scar Symptoms: Pruritus and Pain

Abstract

AbstractScars can present with a wide variety of symptoms relating to appearance, function, as well as sensory disturbances. Pain and pruritus (itch) are by far the most common symptoms in clinical practice; they are often severe and have the propensity to persist over a prolonged period of time following wound healing. Earlier notions supported itch as a sub-modality of pain; however, with recent advances in the pathophysiology field and the delineation of discrete neurological pathways, they are recognized to comprise separate sensory modalities albeit sharing common key features. There is a significant amount of evidence that sensory symptoms can decrease patients’ quality of life in the acute and rehabilitative phase of wound healing and scar formation. This chapter aims to outline the basic pathophysiological processes underlying pain and pruritus in scars and present a variety of options available for management of these symptoms. The section will primarily draws upon scientific and clinical studies relating to burn hypertrophic and keloid scars given that most literature reports have studied sensory disturbances in these subtypes.