BACKGROUND: 3-Hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors, also 
known as statins, are the most commonly prescribed cholesterol-lowering 
medications in the world. Statins have been shown to inhibit connective tissue 
growth factor (CTGF) gene and protein expression in vitro, and previous studies 
in the authors' laboratory have demonstrated that CTGF plays a significant role 
in wound healing and scarring. The authors explore whether administration of 
various statins to healing wounds has any effect on hypertrophic scar formation 
using an established rabbit ear wounding model.
METHODS: Punch wounds were made on the ears of 31 rabbits (n = 372 total 
wounds). Treatment wounds were injected with simvastatin, lovastatin, or 
pravastatin at low, medium, or high doses on postwounding days 15, 20, and 25, 
whereas control wounds were injected in a corresponding fashion. Wounds were 
harvested after 35 days for histomorphometric analysis.
RESULTS: Low-dose (40 μM) simvastatin, lovastatin, and pravastatin each 
demonstrated significant reductions in scar elevation index when compared with 
control: 21.9 percent (p = 0.03), 25.8 percent (p = 0.02), and 22.8 percent (p = 
0.01), respectively. There were no significant differences in scar elevation 
index in the medium- (120 μM) and high-dose (400 μM) statin groups. Analysis of 
mRNA in a subset of rabbits treated with low-dose simvastatin demonstrated a 
significant reduction in CTGF expression (p = 0.009).
CONCLUSIONS: 3-Hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors reduce 
hypertrophic scar formation by means of CTGF inhibition when administered at low 
doses, and the novel application of these commonly prescribed medications may 
lead to innovative and effective antiscarring therapies.