It is important to assess scars in order to discuss the treatment options for different scars and scar-related problems. You can assess the characteristics and severity of a scar using assessment tools, including measurement devices and scar assessment scales.

Scar assessment scales are preferable for daily clinical practice. They are easy to use and inexpensive, so there is no need for training or expensive equipment.

Scar assessment scales

Various scar assessment scales are available, some report only the opinion of the clinician and others include the patient’s perspective.

Clinician-reported scar assessment scales focus on items such as:

Color: white – pink/ purple – red

Thickness: flat – slightly raised – prominent

Consistency: soft – moderately hard – hard

Patient-reported scar assessment scales can also evaluate scar symptoms and quality of life. This is important for all scar treatment modalities, especially surgery. For example, if the patient is satisfied with the scar, the surgeon’s opinion is less important, and surgery may be avoided.

The Patient and Observer Scar Assessment Scale (POSAS) is a frequently used scale. The POSAS measures scar quality by evaluating visual, tactile, and sensory characteristics of the scar from the perspective of the observer (i.e. clinician) and patient.

You can also use scar assessment scales to evaluate the development of a scar over time and to determine the effect of therapy. Be sure to document the outcomes of scar assessment in the patient record.

Measurement devices

Measurement devices are based on various biomechanical techniques with diverse degrees of complexity. They include:

• Colorimetry
• Ultrasound
• Laser
• Oxygen tension
• 3D imaging techniques

These techniques require expensive equipment and trained staff. They are not beneficial for assessing scars in the clinic, but they can be useful for research purposes.