The Latest Strategy for Keloid and Hypertrophic Scar Prevention and Treatment: The Nippon Medical School (NMS) Protocol

J Nippon Med Sch. 2021 Mar 11;88(1):2-9. doi: 10.1272/jnms.JNMS.2021_88-106. Epub 2020 Aug 1.


In 2006, we established a scar/keloid-specialized unit in the Department of Plastic, Reconstructive, and Aesthetic Surgery at Nippon Medical School (NMS) in Tokyo, Japan. In the ensuing 15 years, we treated approximately 2,000 new scar/keloid patients annually. This extensive experience has greatly improved the efficacy of the treatments we offer. Therefore, we discuss here the latest NMS protocol for preventing and treating keloids and hypertrophic scars. While this protocol was optimized for Japanese patients, our experience with a growing body of non-Japanese patients suggests that it is also effective in other ethnicities. The extensive evidence-based experience underlying the NMS protocol suggests that it may be suitable as the foundation of a standard international prevention/treatment algorithm for pathological scars.

Keywords: hypertrophic scar; keloid; wound.

Publication types

  • Review

MeSH terms

  • Adrenal Cortex Hormones / administration & dosage
  • Algorithms
  • Cicatrix, Hypertrophic / etiology
  • Cicatrix, Hypertrophic / pathology
  • Cicatrix, Hypertrophic / prevention & control*
  • Cicatrix, Hypertrophic / therapy*
  • Combined Modality Therapy
  • Evidence-Based Medicine
  • Female
  • Follow-Up Studies
  • Hospitals, University*
  • Humans
  • Japan
  • Keloid / etiology
  • Keloid / pathology
  • Keloid / prevention & control*
  • Keloid / therapy*
  • Laser Therapy
  • Male
  • Patient Education as Topic
  • Radiotherapy, Adjuvant
  • Risk
  • Schools, Medical*
  • Surgery Department, Hospital*
  • Triamcinolone Acetonide / administration & dosage


  • Adrenal Cortex Hormones
  • Triamcinolone Acetonide