Scar Redness in Humans: How Long Does It Persist after Incisional and Excisional Wounding?

Background: The natural history of scar redness in humans has never been formally described, and the point at which normal scar redness fades is unknown. Methods: As part of a randomized, placebo-controlled, clinical trial investigating the effects of various doses of transforming growth factor-β3 on scar quality, the authors observed the process of scar redness and maturation in non-drug-treated incisional and excisional wounds made on the upper inner arms of 103 volunteers. Scar photographic images were assessed by a review panel to ascertain the month during which redness faded for a particular scar. Scar histology documented the level of inflammation and angiogenesis. Results: Scar redness faded at an average of 7 months. Scar redness for incisions faded significantly faster than excisions (p = 0.0001, Kruskal-Wallis test), and significant differences were also seen between anteriorly and posteriorly placed scars for incisions (p = 0.0008) and excisions (p = 0.0035), respectively. Month 12 histologic examination revealed the absence of any ongoing inflammatory processes in all scars. Conclusions: Scar redness fades on average at 7 months. This is influenced by the wound type and position. The authors advocate the use of the term “rubor perseverans” to describe the physiologic redness of a normal scar as it matures beyond the first month, a process that does not involve inflammation.