What are Hypertrophic Scars?
Hypertrophic scars, also known as keloid scars, are characterized by an overgrowth of scar tissue at the site of a skin injury such as a surgical incision or burn. They appear raised, lumpy and red and are usually quite different from the surrounding uninjured skin. It continue to grow for several months after the wound or injury has healed instead of lying flat like an ordinary scar.
Causes of Hypertrophic Scarring
The exact cause of hypertrophic scarring is unknown, but it is believed to be related to an overproduction of collagen (fibrous protein in connective tissues such as skin, tendons and ligaments) during the wound healing process. Hypertrophic scarring occurs when the wound healing response produces an abundance of collagen beyond what is needed for normal wound repair. Some of the factors that can increase the risk of hypertrophic scarring include:
- Genetic predisposition - Certain ethnic groups like black, Hispanic and Asian populations are more prone to developing these raised scars.
- Wound location - Sites such as shoulders, chest, back and arms have a higher risk of hypertrophic scarring.
- Severe injuries - Deep burn wounds, crush injuries or wounds with extensive tissue loss heal with hypertrophic scarring more frequently.
- Young age - Hypertrophic scarring is more common in children and teenagers as their skin is still developing.
- Other pre-existing skin conditions - Conditions like keloids (due to genetic skin disorder) increase risk of hypertrophic scarring after any new injury.
- Scar immaturity - Application of pressure or friction to scars less than 18 months old predisposes to hypertrophic scars.
Characteristics
The hallmark of hypertrophic scars is the firm, raised scar tissue that grows beyond the original boundaries of the wound. Other distinguishing features are:
- Color - They appear dark red, pink or purple compared to the surrounding flesh-colored normal scar.
- Texture - Hypertrophic scars feel nodular, bumpy and lichenified (thickened and leathery).
- Flexibility - They lack normal skin pliability and tend to restrict joint motion if present over mobile areas.
- Maturity - Most evident during first year after injury, then gradually soften, flatten and fade over several years. However, some persist as permanent scars.
- Appearance - Shape remains similar to original injury but size can vary greatly from a few millimeters to many centimeters wide.
Treatment Options
Currently there is no cure for established hypertrophic scars, but certain treatments can improve their appearance and symptoms:
Topical medications: Creams containing corticosteroids (like clobetasol), retinoids (vitamin A derivatives) or silicone gels can flatten and soften scars if applied regularly for at least 3 months.
Pressure therapy: Wearing compression garments or pressure dressings helps restrict scar widening due to its flattening effect. This is effective as adjunct to other therapies.
Injectable corticosteroids: Direct injections of corticosteroids into scars every 4-6 weeks helps control their growth and proliferation of connective tissues.
Laser therapy: Pulsed dye laser is a safe, non-invasive option to flatten and lighten red colored scars by targeting hemoglobin in blood vessels. Multiple sessions are required.
Surgery: Procedures like scar revision or excision are suitable after scar maturation (1-2 years) and when non-invasive measures fail.
Other adjuvant therapies like cryotherapy (use of cold), radiotherapy, corticosteroid tape or scar massage may be tried as part of integrated management approach by a dermatologist. Prompt treatment helps achieve the best outcomes with hypertrophic scarring.
Summary
In summary, hypertrophic scars occur due to abnormal wound healing response causing overgrowth of scar tissues at the site of injury. Factors like genetics, wound depth and location influence risk of such pathological scarring. While they lack a cure, early integrated management with topical agents, pressure therapy and procedures provide good control of these raised scars and improved cosmetic outcomes. Prompt identification and timely intervention help achieve best results.
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Ravina Pandya, Content Writer, has a strong foothold in the market research industry. She specializes in writing well-researched articles from different industries, including food and beverages, information and technology, healthcare, chemical and materials, etc. (https://www.linkedin.com/in/ravina-pandya-1a3984191)
*Note:
1. Source: Coherent Market Insights, Public sources, Desk research
2. We have leveraged AI tools to mine information and compile it
