Silicone-based agents are recommended after wound epithelialization for >12 h per day until scar maturation (high-level evidence). For established scars, the topical application of silicone gel is recommended to soften the scars and alleviate itching, pain, and redness (moderate-level evidence). For well-healed wounds, silicone gel sheets/tapes are prioritized for preventing scar hypertrophy. If the newly formed skin is thin and fragile, silicone gel may be used initially, with gradual transition to silicone gel sheets/tape based on wound condition (strongly recommended) (evidence level: moderate).

Topical application of medications containing onion extract on the scar surface twice daily for at least 28 d is recommended to improve scar thickness, redness, itching, hyperpigmentation, and pain (moderately recommended)(evidence level: moderate)

Pressure therapy is recommended to commence as soon as wound epithelialization is complete. Pressure should be maintained in the range of 2.00‒5.33 kPa with a daily treatment duration of at least 23 h (strongly recommended) (evidence level: moderate)

The advent of affordable 3D scanning and printing has been an important recent development allowing for tailor-made solutions. Transparent masks produced via 3D scanning and printing are recommended for pediatric facial scar prevention and treatment and can be combined with silicone to increase pressure in specific areas and protect the skin, reducing the impact on the growth and development of facial bones and teeth (moderately recommended) (evidence level: low).

Combining pressure therapy with silicone-based medications or laser therapy for wounds that have achieved re-epithelialization is recommended (strongly recommended) (evidence level: moderate)

Laser therapy is recommended to be initiated at 1‒2 weeks after traumatic wound healing, 2 weeks after burn healing, and 2‒4 weeks after skin grafting (moderately recommended) (evidence level: low) .

The use of pulsed-dye laser (PDL), intense pulsed light (IPL), or fractional CO₂ laser for the prevention of scar hypertrophy is recommended (moderately recommended) (evidence level: low).

For children with thickened scars accompanied by pain and itching, low-energy fractional CO₂ laser treatment is recommended (strongly recommended) (evidence level: high).

For pediatric hypertrophic scars accompanied by pruritus, pain, or significant thickening, a treatment regimen combining a fractional CO₂ laser with topical drug delivery is recommended (evidence level: low). PDL combined with fractional CO₂ lasers or compression therapy is also recommended to reduce scar erythema, improve thickness, and modulate biomechanical properties (moderately recommended) (evidence level: high).

An ablative fractional laser is recommended as the primary option for treating mild scar contracture in children. The appropriate laser energy should be selected based on the thickness of the scar. PDL can also be used in combination (moderately recommended) (evidence level: moderate).

Combining laser therapy with functional exercise and rehabilitation for pediatric scar contractures is recommended (weakly recommended) (evidence level: very low).

The use of local anesthetics or cold sprays during laser therapy for pain management is recommended (moderately recommended) (evidence level: moderate)

It is recommended to adopt a rehabilitation philosophy of “early intervention, comprehensive management, and continuous follow-up” by implementing an integrated scar rehabilitation program that incorporates kinesiotherapy, scar massage, and play therapy as early as possible (moderately recommended) (evidence level: low).

It is recommended that rehabilitation therapy, including exercise and scar massage, be conducted under the guidance of a therapist in a healthcare facility or at home. When scar massage is performed, ample pressure should be applied to improve tissue elasticity and pliability (moderately recommended) (evidence level: very low)