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Psychological Impact of Hypertrophic Scars: An Analytical and Integrative Review

INTRODUCTION Hypertrophic scars are characterized by excessive collagen deposition, leading to raised, red, and rigid scars. They arise from an abnormal wound healing process, often affecting individuals with darker skin and those with a family history of abnormal scarring. These scars can cause significant physical and aesthetic issues, leading to contractures and profound psychological distress. Patients often experience low self-esteem, social anxiety, and depression, which negatively impact their quality of life. Effective management requires a multidisciplinary approach, integrating medical and psychological interventions to address both the physical and emotional burden of hypertrophic scars. OBJETIVE to review the psychological aspects of hypertrophic scars, including the prevalence of anxiety and depression, impact on quality of life, and effectiveness of psychological interventions and coping strategies. METHODS This is a narrative review which included studies in the MEDLINE – PubMed (National Library of Medicine, National Institutes of Health), COCHRANE, EMBASE and Google Scholar databases, using as descriptors: “Hypertrophic Scars” AND “Psychological Impact” AND “Quality of Life” AND “Coping Mechanisms” AND “Interdisciplinary Care”in the last years. RESULTS AND DISCUSSION Patients with hypertrophic scars frequently exhibit anxiety, depression, and reduced quality of life. Studies show a direct correlation between the visibility of scars and psychological distress. Adaptive coping strategies, such as seeking social support, improve psychological outcomes, whereas maladaptive strategies exacerbate distress. Social relationships are often strained, leading to social isolation. Self-esteem and body image are significantly affected, with visible scarring lowering self-esteem. Psychological interventions like cognitive-behavioral therapy (CBT) have proven effective in reducing psychological symptoms. Patient education and support groups are crucial in improving outcomes. An interdisciplinary approach, considering cultural and societal factors, is essential for comprehensive care. Future research should focus on long-term psychological outcomes and innovative treatment approaches. CONCLUSION Hypertrophic scars impose significant physical and psychological challenges, necessitating holistic treatment approaches. Psychological interventions, patient education, and support groups play critical roles in mitigating distress. An interdisciplinary approach that addresses both physical and psychological dimensions is essential. Future research should explore innovative therapies and personalized treatment plans to enhance care. By addressing these aspects, healthcare providers can significantly improve the overall well-being and quality of life for patients with hypertrophic scars
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Psychological Impact of Hypertrophic Scars: An Analytical and Integrative Review

  • DOI: https://doi.org/10.22533/at.ed.1594492431055

  • Palavras-chave: Dermatology; Plastic Surgery; Mental Health.

  • Keywords: Dermatology; Plastic Surgery; Mental Health.

  • Abstract: INTRODUCTION Hypertrophic scars are characterized by excessive collagen deposition, leading to raised, red, and rigid scars. They arise from an abnormal wound healing process, often affecting individuals with darker skin and those with a family history of abnormal scarring. These scars can cause significant physical and aesthetic issues, leading to contractures and profound psychological distress. Patients often experience low self-esteem, social anxiety, and depression, which negatively impact their quality of life. Effective management requires a multidisciplinary approach, integrating medical and psychological interventions to address both the physical and emotional burden of hypertrophic scars. OBJETIVE to review the psychological aspects of hypertrophic scars, including the prevalence of anxiety and depression, impact on quality of life, and effectiveness of psychological interventions and coping strategies. METHODS This is a narrative review which included studies in the MEDLINE – PubMed (National Library of Medicine, National Institutes of Health), COCHRANE, EMBASE and Google Scholar databases, using as descriptors: “Hypertrophic Scars” AND “Psychological Impact” AND “Quality of Life” AND “Coping Mechanisms” AND “Interdisciplinary Care”in the last years. RESULTS AND DISCUSSION Patients with hypertrophic scars frequently exhibit anxiety, depression, and reduced quality of life. Studies show a direct correlation between the visibility of scars and psychological distress. Adaptive coping strategies, such as seeking social support, improve psychological outcomes, whereas maladaptive strategies exacerbate distress. Social relationships are often strained, leading to social isolation. Self-esteem and body image are significantly affected, with visible scarring lowering self-esteem. Psychological interventions like cognitive-behavioral therapy (CBT) have proven effective in reducing psychological symptoms. Patient education and support groups are crucial in improving outcomes. An interdisciplinary approach, considering cultural and societal factors, is essential for comprehensive care. Future research should focus on long-term psychological outcomes and innovative treatment approaches. CONCLUSION Hypertrophic scars impose significant physical and psychological challenges, necessitating holistic treatment approaches. Psychological interventions, patient education, and support groups play critical roles in mitigating distress. An interdisciplinary approach that addresses both physical and psychological dimensions is essential. Future research should explore innovative therapies and personalized treatment plans to enhance care. By addressing these aspects, healthcare providers can significantly improve the overall well-being and quality of life for patients with hypertrophic scars

  • João Lucas de Quadros da Silva
  • Danielli Regina da Silva
  • Leonardo Ribeiro Rojo
  • Caroline Zaninelli Cremonez
  • Miguel Carra Gava
  • Sofia Fontanesi de Camargo
  • Chadia Abrão
  • Danielle Costa Pires
  • Larissa Leite Coletto
  • Luana Nogueira de Mendonça
  • Maysa de Oliveira Rosa Duarte
  • Mauricio Lopes da Silva Netto
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