Vancouver Scar Scale (VSS)
4-item clinical scar assessment tool evaluating vascularity, pigmentation, pliability, and height. Total score 0–13; higher score = worse scar. Used to assess burn scars, surgical scars, and response to treatment (silicone gel, pressure garments, laser therapy).
Score interpretation
VSS 0–1 — near-normal scar; mature or minimal
→ No active treatment needed; sun protection; moisturiser; reassess at 6 months; document for baseline comparator in future treatments
VSS 2–5 — mild to moderate scar; consider treatment
→ Silicone gel sheeting (12 hours/day for ≥3 months); sun protection; scar massage 5–10 min twice daily; reassess every 3 months; consider pressure garment for burn scars; avoid UV exposure to scar area
VSS 6–9 — moderate to severe hypertrophic or keloidal scar
→ Refer to plastic surgery or dermatology; combined modalities: intralesional corticosteroids, silicone, pressure; fractional laser (CO2 or Er:YAG); reassess every 6–8 weeks during treatment; functional impairment from contracture requires urgent surgical input
VSS 10–13 — severe scar, likely contracture; functional impact probable
→ Urgent plastic surgery referral; surgical release if contracture limits function; skin grafting, Z-plasty, flap reconstruction; laser therapy post-healing; physiotherapy for range of motion; occupational therapy for ADL impact; psychological support
Interpretation bands for the Vancouver Scar Scale. Apply clinical judgement and local guidance.
References
- Sullivan T et al. Rating the burn scar. J Burn Care Rehabil. 1990;11(3):256–260.
Related
Curated clinical cross-links plus same-class fallbacks.
- Triamcinolone Acetonide (Intralesional — Keloid/Scar) · Corticosteroid — Intralesional Scar Treatment
- 5-Fluorouracil (Intralesional — Keloid/Scar) · Antimetabolite — Intralesional Scar Treatment
- Silver Sulfadiazine 1% Cream · Topical antimicrobial / Burn wound dressing
- Mafenide Acetate 5% · Topical antibacterial (sulfonamide derivative) — deep burn wounds
- Vitamin E (Tocopherol — Topical Scar Management) · Topical Nutritional / Scar Management
- Silicone Gel / Sheeting (Scar Management) · Medical Device / Topical Scar Treatment
- Suspicious Pigmented Lesion — Melanoma Pathway · NICE NG14 2015 / BAD
- Cellulitis and Erysipelas · NICE NG141 2019 / CREST
- Psoriasis — Severity Assessment and Step-Up Therapy · NICE NG153 2019 / BAD
- Atopic Eczema — Assessment and Step-Up Therapy · NICE NG95 2023
- Urticaria and Angioedema · BSACI / EAACI Guidelines 2022
- Acne Vulgaris — Grading and Treatment · NICE NG198 2021 / BAD
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.