Facial Scarring in Pediatric Patients: An Analysis of the Recommendations and Disparities in Scar Management

Introduction: Facial scarring can have long-lasting effects on the physical appearance and emotional well-being of all patients, especially children. There is little research and few established standards regarding scar management. This study aims investigate the current recommendations for scar management in pediatric patients.

Methods: Retrospective chart review of ambulatory patients (age 0-17 years) diagnosed and treated for lacerations of the face from 2012-2023. Clinical and demographic data were extracted from the medical record analyzed using descriptive statistics.

Results: A total of 1,015 patients were identified and 398 were included. On average, patients were 7 years old (± 5 years) with a laceration length of 2.3 cm (± 2.4 cm). The most recommended aftercare was SPF use/sun avoidance (83%). Patients received an average of 1 recommendation. Scar length positively influenced the number of recommendations given; whereas scar depth did not. (p = 0.049, p = 0.07). We found no association between laceration repair service and number of recommendations provided (p = 0.4). Those whose lacerations were repaired more recently were given more recommendations (p < 0.05). When isolating African Americans and Caucasians, African Americans were more often given fewer recommendations (p = 0.03) than Caucasian patients.

Conclusions: Despite the increase in management recommendations over the years, overall, recommendations have been inadequate. Effective practices including silicone sheeting and petroleum jelly use are not as frequently recommended to patients. Furthermore, there exists a racial bias against African Americans receiving equal recommendations. More work is needed to elucidate the long-term effects of racial this discrepancy and develop effective methods to increase scar management education.