Which (type of) outcome measurement instruments are being used to measure scar quality?

And which scar characteristics do they most frequently assess?

Measurements of scar quality can be performed by different types of outcome measurement instruments, including measurement devices and scar assessment scales. Measurement devices are machines which usually measure one characteristic of scar quality. Scar assessment scales allow for the evaluation of multiple characteristics of scar quality, from the clinician and/or the patient perspective. Clinician-reported scar scales capture clinicians’ opinion on visual and tactile characteristics, while patient-reported scales enable the assessment of sensory characteristics in addition to patients’ opinion on the visual and tactile characteristics of their scar(s).

A recent systematic review [1] provided an overview of all the outcome measurement instruments (and its content) used in the literature to measure scar quality (in patients with all types of scars). This review showed that of the 909 included instruments:

  • 41% were clinician-reported scales
  • 30% were measurement devices
  • 26% were patient-reported scales
  • 3% were combined clinician- and patient-reported scales

Of all clinician-reported scales, the second version of the Patient and Observer Scar Assessment Scale (POSAS) was most frequently (70 times) reported. The Cutometer, which measures the elasticity of the skin, was the most frequently (32 times) used measurement device. The Patient Scale of the first and second POSAS version, which are identical, was the most frequently (111 times) reported patient-reported scale in this study. The modified Vancouver Scar Scale by Nedelec et al. was the most often used (nine times) combined clinician- and patient-reported scales

 Order of most frequently assessed items
Type of instrumentFirstSecondThirdFourthFifth
Clinician-reported scar scaleThicknessPigmentationVascularityPliabilitySurface irregularity
Patient-reported scar scalePainItchColorThicknessPliability
Measurement deviceVascularityPliabilityThicknessPigmentationMoisture


[1] Systematic Review on the Content of Outcome Measurement Instruments on Scar Quality. Carrière, M.E. et al. PRS Global Open, 2019.