Treatments for Hypertrophic Scars

Hypertrophic scars are characterized by their thick, wide, and often raised appearance, forming over areas of skin injury. Treatment options vary from professional interventions in a doctor’s office to home remedies, depending on the desired speed of minimizing their visibility.

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Understanding Hypertrophic Scars | Treatment Options | Medical Approaches | Home Remedies | Hypertrophic vs. Keloid Scars | Prevention

What are hypertrophic scars?

A hypertrophic scar is a thickened, wide, and often raised mark that forms after skin injury. While scars are a natural part of healing, hypertrophic scars result from an abnormal response to trauma.

Certain individuals, due to their skin type or healing tendencies, may produce excess collagen during the wound healing process. Factors like infection, inflammation, tension, or leaving wounds unstitched can contribute to collagen overproduction, leading to hypertrophic scars.

These scars commonly occur after burns but can also develop from piercings, cuts, or acne. Though similar to keloid scars, hypertrophic scars usually remain within the boundaries of the original injury.

While not life-threatening, hypertrophic scars can be itchy, painful, or cosmetically bothersome. Treatment options vary but may include topical treatments, silicone sheets, corticosteroid injections, or laser therapy to reduce scar appearance and discomfort.

How are hypertrophic scars treated?

Your doctor may suggest various treatments to flatten and reduce your scar.

It’s crucial to understand that scar maturation takes time—up to a year. During this period, your body naturally remodels and improves scar tissue. As a result, doctors often advise waiting several months to a year before initiating any treatment for early hypertrophic scars.

Medical treatments

Corticosteroid treatments: Corticosteroid injections are a primary choice for treating hypertrophic scars. These injections, administered every six weeks, can help flatten and soften the scar. However, there’s a limit to their use due to potential weakening of surrounding tissue.

Laser therapy: Laser treatment is most effective for newer scars, aiming to burn and flatten raised scars while targeting pigmentation to lighten them.

Bleomycin: Injecting Bleomycin directly into the scar shows promise in improving appearance and relieving symptoms like itching and pain. Further trials are needed for conclusive evidence.

Cryotherapy: Freezing scar tissue with liquid nitrogen can effectively flatten hypertrophic scars, with studies showing it to be safe and well-tolerated.

Surgery: After allowing the scar to mature for at least a year, surgical excision followed by closure with stitches can remove hypertrophic scars, addressing underlying issues like infection and tension.

Home treatments

Silicone sheets: Silicone elastomer sheets are a noninvasive and widely recommended treatment for hypertrophic scars. Available in various forms like sheets, gels, sprays, and foams, they’re applied over the scar for several hours daily for a few months.

Pressure and massage: Applying pressure and massaging the scar area is a cost-effective method to promote healing. Using bandages or tape for pressure can gradually weaken scar tissue and improve its appearance over time.

Onion extract creams: Over-the-counter topical gels containing onion extract, such as Mederma, are available but their effectiveness in reducing hypertrophic scars is supported by limited clinical data.

Bio Oil: Bio Oil is a popular treatment for scars, though larger clinical trials are needed to validate its effectiveness in reducing hypertrophic scars. It’s readily available at beauty supply stores.

If you need assistance in finding a primary care doctor, you can use our FindCare tool.

Hypertrophic scars vs. keloid scars

Before starting treatment for a hypertrophic scar, it’s crucial to differentiate it from keloid scars, a similar type of scar. Keloids are smooth, hard, benign growths that form when scar tissue grows excessively. Distinguishing between the two is essential as treatment approaches may vary.

Hypertrophic scars typically:

  • Are raised, but usually less than 4 millimeters above the skin’s surface
  • Exhibit a red or pink coloration
  • Can develop on any part of the body

In contrast, keloids usually:

  • Are raised more than 4 millimeters from the skin
  • Extend beyond the original incision or wound boundaries
  • Have a pink to purple hue
  • Evolve and enlarge over time
  • Commonly occur on the earlobes, shoulders, cheeks, and chest above the sternum

Both types of scars are more prevalent in darker skin types. While hypertrophic scars are generally easier to treat, keloids often recur despite treatment efforts.

Preventing hypertrophic scars

If you’ve experienced an injury, particularly a burn injury, or undergone surgery, there are steps you can take to minimize the risk of hypertrophic scarring:

  • Ensure proper wound care and cleanliness to prevent infection, including the use of wound dressings.
  • Consider using silicone sheeting post-surgery, which has shown effectiveness in scar prevention.
  • Discuss the option of corticosteroid injections with your healthcare provider after surgery to reduce scar formation.

Research suggests that immediately cooling a burn with cold water compresses and applying tea tree oil may aid in better skin healing, potentially preventing hypertrophic scars. However, further studies are needed to confirm these findings.

Jump to section

Understanding Hypertrophic Scars | Treatment Options | Medical Approaches | Home Remedies | Hypertrophic vs. Keloid Scars | Prevention