Hypertrophic Scars

The scars caused by increased tissue formation are called hypertrophic scars. This type of scar looks like a raised, firm mass of tissue, often red, inflamed, itchy, painful.

They remain with the boundary of the original wound.
The typical hypertrophic scar from acne is 1-2 millimeters in width, but some may be much larger.

Hypertrophic scars remain limited to the traumatized area and regress spontaneously within 12-24 months, although regression may not necessarily be complete.

Prevention is key, but therapeutic treatment of hypertrophic scars and keloids includes occlusive dressings, compression therapy, intralesional corticosteroid injections, excision, laser therapy

The most standard treatment for these types of scars is the injection of steroids directly into the scar to help soften and flatten the scars, as well as the application of silicone sheets or gel.

Compression therapy involves pressure, which has long been known to have thinning effects on skin. Reduction in the cohesiveness of collagen fibers in pressure-treated hypertrophic scars has been demonstrated by electron microscopy.

Steroid inhibits fibroblast growth, reducing the amount of collagen deposited into the scar. The most commonly used corticosteroid is triamcinolone acetonide (TAC) in concentrations of 10-40 mg/mL administered intralesionally with a 25- to 27-gauge needle at 4- to 6-week intervals.

A series of studies suggest that the pulsed-dye laser appears to be a very promising tool for treating hypertrophic scars and keloids. It is hypothesized that by destroying the smallest blood vessels, localized reduction of oxygen may stimulate collagenase (which breaks down collagen).

In all cases, dicuss your options thoroughly and only with a board certified plastic surgeon to find a successful approach to combating hypertrophic scarring.

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