Hypertrophic Scar

The term hypertrophy means increase in volume of a tissue or organ produced entirely by enlargement of existing cells.

Hypertrophic scars heal above the surface of the skin

A hypertrophic scar is therefore a scar that has healed overzealously above the skin surface. The scar does not extend past the confines of the original wound but rather becomes raised creating an unsightly red scar which may be itchy and even painful.

Hypertrophic scars can occur in any race or any aged person at any site however the risk of their development decreases as a person ages. The scar will appear worse in the first 2 weeks to 2 months of development and over time will flatten and become paler in color.

Only humans develop hypertrophic scars

Hypertrophic scars are unique to humans however studies have not been able to pinpoint the etiology of the abnormal scars development. It is known that in the formation of hypertrophic scars there is an increase in collagen (a fibrous protein) production or a decrease in collagen degradation.

Almost all hypertrophic scars are associated with surgery, infection, tattoos, burns, injections, bites, vaccinations and trauma. Skin tension is also often a factor. The abnormal scar often develops over an area where the skin is naturally taught, such as the anterior chest, shoulders and upper back.

Hypertrophic scars cause disfigurement

The main concern for a person with a hypertrophic scar is the disfigurement, however pain, itchiness, and loss of motion from contractures may also be a problem. Surgical correction of the scar may be required if these symptoms become worrisome.

Surgery is only considered when non surgical methods have proved ineffective. It pays to remember that over time the severity of hypertrophic scars will lessen so where possible controlling symptoms to minimize discomfort in the short term is all that is required.

Medical intervention the best option

Medical intervention is the best option when treating hypertrophic scars. The use of pressure to decrease tissue metabolism and increase collagen breakdown is a common form of treatment.

Silicone gel applied directly to the scar has also proved effective however it needs to be used with care as it has been associated with skin breakdown and rashes. Intralesional injections of corticosteroids are also an effective and common choice of treatment as they induce fading and flattening of the scar thereby decreasing symptoms.