Pathologic scarring affects millions of people worldwide. Quantitative and qualitative measurement modalities are needed to effectively evaluate and monitor treatments. This article reviews the literature on available tools and existent assessment scales used to subjectively and objectively characterize scar. We describe the attributes and deficiencies of each tool and scale and highlight areas where further development is critical. An optimal, universal scar scoring system is needed in order to better characterize, understand and treat pathologic scarring.