Hypertrophic scar is a pathological lesion during the repair of skin wound, involving fibroblast, extracellular matrix and cytokines. The prevention and treatment of hypertrophic scar has been a clinical problem, but its exact mechanism is still unclear. The renin angiotensin system (RAS) in the skin is proved to directly involve in wound healing and hypertrophic scar formation. After local RAS activating during wound repair, the expression of angiotensinogen Ⅱ (Ang Ⅱ) and angiotensin converting enzyme (ACE) have increased. They can lead to pathological scarring by stimulating the proliferation of fibroblasts in the skin, affecting collagen metabolism, promoting skin fibrosis and angiogenesis. This review will focus on the role of Ang Ⅱ and ACE in hypertrophic scar formation, which will help to further understand the mechanism of scar formation, and summarize the potential application of RAS antagonists in hypertrophic scar prevention and treatment, so as to provide a new direction for the prevention and treatment of hypertrophic scar.

Hypertrophic scar is a pathological lesion during the repair of skin wound, involving fibroblast, extracellular matrix and cytokines. The prevention and treatment of hypertrophic scar has been a clinical problem, but its exact mechanism is still unclear. The renin angiotensin system (RAS) in the skin is proved to directly involve in wound healing and hypertrophic scar formation. After local RAS activating during wound repair, the expression of angiotensinogen Ⅱ (Ang Ⅱ) and angiotensin converting enzyme (ACE) have increased. They can lead to pathological scarring by stimulating the proliferation of fibroblasts in the skin, affecting collagen metabolism, promoting skin fibrosis and angiogenesis. This review will focus on the role of Ang Ⅱ and ACE in hypertrophic scar formation, which will help to further understand the mechanism of scar formation, and summarize the potential application of RAS antagonists in hypertrophic scar prevention and treatment, so as to provide a new direction for the prevention and treatment of hypertrophic scar.