At first glance, you may be confused as to why there is an ethnic distinction in scar treatment, is scarring different from other ethnic groups in Asia? The answer is yes, Asian skin is not only different from Caucasian (European and American) skin in terms of skin color, but also in terms of skin scarring. Because of this, the scar treatment guidelines for Asian patients, just published this year, written by renowned experts from various Asian countries, are particularly valuable and significant, providing a model for scar diagnosis and treatment in China. Zang Mengqing, Department of Plastic and Reconstructive Surgery, Chinese Academy of Medical Sciences, here would like to share some important information of the guidelines with you in the hope that it will be helpful for scar patients. First, to introduce you to the fact that Asians are more prone to develop proliferative keloid scars than Caucasians. Asians have thicker skin and more active fibrous proliferation, which results in Asians being more prone to keloid hyperplasia and hyperpigmentation after skin trauma, as well as longer time to scar maturation (longer time to scar redness). Second, for the first time, the guidelines suggest that all Asian patients need scar prophylaxis after surgery. This is different from the 2001 international expert consensus (only patients with high risk factors need scar prophylaxis). Once again, we would like to briefly introduce the treatment recommendations in the guidelines: I. Treatment guidelines for hyperplastic scar: 1. Piecewise hyperplastic scar with scar contracture: perform a thorough scar release surgery, apply a skin graft or flap to repair the wound, and perform scar prophylaxis after the repair. 2.Linear hyperplastic scar with scar contracture: excision followed by suturing, long-term postoperative follow-up and scar prophylaxis; if the hyperplastic scar recurs, re-operation and combined radiotherapy or intra-scar hormone injection are required; if it recurs again, no surgery is performed and only conservative treatment is carried out. 3. Proliferative keloid scar without scar contracture: only non-surgical combined treatment with multiple methods, such as silicone gel, laser, etc., long-term follow-up and conservative treatment are required. 2. Treatment guidelines for keloid scars: There are two types of treatment: surgical and non-surgical. Non-surgical treatment: 1. Small solitary keloid: single treatment method, such as hormone injection in the scar or laser treatment or cryotherapy or anti-tumor drug injection in the scar, if it is ineffective, replace the other treatment methods above or choose surgery. 2. Large multiple keloids: Combined treatment with multiple methods, including intra-scar hormone injection, laser treatment, cryotherapy, intra-scar anti-tumor drug injection, silicone gel, etc., and if ineffective, surgery will be considered. Surgical treatment: to be used when non-surgical treatment is ineffective 1. Small solitary keloid: surgical excision combined with radiotherapy or intra-scar hormone injection, or only radiotherapy or intra-scar hormone injection if recurrence. 2. Large multiple keloid scars: partial excision or only symptom relief if the result is not good. All keloids require long-term follow-up and preventive treatment after effective treatment. Finally, some noteworthy points are presented to you: 1. For hyperplastic keloids, silicone gel gel and silicone gel sheet are equally effective in preventing hyperplastic keloids, but the former is more convenient to use and facilitates patient adherence; multiple sessions of low-frequency pulsed dye laser can prevent hyperpigmentation in Asian patients with hyperplastic keloids. 2. For keloid scars, intra-scar hormone injections alone can effectively relieve the symptoms of keloid scars in Asian patients; surgical excision combined with intra-scar hormone injections or other adjuncts are effective and safe for the treatment of keloid scars; higher doses of radiation therapy and self-care are needed for areas with a high recurrence rate of keloid scars (e.g., anterior chest, scapular region, and pubic mound); the carcinogenic rate of radiation therapy is minimal.