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Hypertrophic and contracture scars are common problems after burn injuries and cause functional and cosmetic deformities. A wide variety of treatments has been advocated for postburn pathologic scars regression. Unfortunately, the reported efficacy has been variable.To investigate the use of extracorporeal shock wave therapy (ESWT), which mainly targets the fibroblasts in scar tissue, as an effective modality for scar treatment in burn patients.An experimental study with ESWT was performed in 16 patients with postburn scars contractures, hypertrophic scars, or keloids twice a week for 6 weeks. Digital photographs were obtained and visual analogue scales were completed before and after treatment.Already after the first session, scars appeared more pliable, and color mismatch was less evident. At the end of the study period, all treated scars obtained a more acceptable appearance.Extracorporeal shock wave therapy is a feasible and cost-effective treatment in the management of postburn pathologic scars.