Van de Kar et al developed patient and observer scales for evaluating a scar. These can be used to evaluate a scar and any response to treatment to improve its appearance. The authors are from VU University and Red Cross Hospital in Amsterdam and Beverwijk, the Netherlands.


Modifications from the original scale:

(1) use of a 10 cm VAS scale rather than a 10 point itemized scale

(2) addition of an item for overall bother

(3) change in "overall opinion" to "overall appearance"


Items describing the scar:

(1) pain

(2) itching (pruritus)

(3) color difference from skin color

(4) stiffness

(5) thickness or retraction compared to adjacent skin

(6) irregularity

(7) overall appearance

(8) overall bother


Visual analogue scale for each item: 10 cm line


Distance Along VAS Scale


0 cm


5 cm

moderate to marked

10 cm



Significant items (the cutoff can be adjusted for the patient):

(1) Any item scored >= 7 cm

(2) An overall score >= 5 cm


One use of the scale is for evaluating a response to therapy, with reduction in scores indicating improvement.


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