A hypertrophic scar is a condition that happens when there is a rise in the amount of collagen which gives rise to a raised scar but not as severe as a keloid scar. Just as with keloid scars, a hypertrophic scar forms at the sites of pimples, body piercings, cuts and burns. A lot of these types of scars contain nerves and blood vessels and tend to develop after your skin has suffered a thermal or traumatic injury that affects the deeper layers of the skin.
There is another type of raised scar apart from hypertrophic scar which is called a keloid scar. The main difference is that the keloid scar is a tougher heaped-up scar that rises suddenly from the rest of the skin. It has a smoother top and is pinkish or purple in color. Keloid scars are irregularly shaped and do not subside over time like other types of scarring. As with hypertrophic scars, they are highly unsightly and become itchy and painful. Hypertrophic scars tend to be more reddish and can subside by themselves over a long period of time without treatments.
When a normal wound heals by itself, the body automatically produces new collagen fibers at a balanced rate that breaks down the old collagen. Hypertrophic scars are thick and red and may become itchy and painful. The never extend beyond the boundaries of the original wound. They may continue to thicken for up to six months, but they usually improve over the span of one to two years. Depending on the trauma, it may cause added distress due to their appearance or the intensity of the itching; furthermore, if located close to a joint, it could restrict movement to that specific area.
The Many Different Treatment Options for Hypertrophic and Hypertrophic Acne Scars
The very first thing to do when trying to get rid of your hypertrophic scars is to talk to your dermatologist. Since they specialize in the field of medicine for your skin, it should be their call what the best procedure to use is. All the things that should and will be considered are the location of the scar, the size of the scar and how long the scar has been there. These factors will help your dermatologist decide the best course of action to treat your scarring. Often times, a treatment plan will include more than one treatment procedure. This is because raised scars respond better to different types of treatments than if you were to use only one.
One of the first procedures a dermatologist will use is an injection. These injections are called intralesional injections and are designed to shrink raised scars. You are injected with a series of corticosteroids which soften and flatten thick raised scars. Your dermatologist will commonly give you a series of injections which are spaced out to be given every few weeks. The exact frequency will depend on the type of scar and other contributing factors. So for some patients, they might receive an injection every two to three weeks while another patient might receive injections every three to six weeks. Usually, if a scar does not respond or has stopped responding after the fourth consecutive injection, then your dermatologist may recommend the next step of scar surgery.
As said, if your scar doesn’t seem to respond to injections, then the next step would be the recommendation of scar removal surgery. When treating raised scars, dermatologists say that it is best not use surgery as the only way to treat them. This is because if a raised scar is treated only by surgery, then there is a high risk that the raised scar will return and in some cases, can be worse than it was before. To prevent this, dermatologists use other treatments before and after the surgery. There are three procedures that are most commonly used to accompany surgery. The first one is the use of pressure after surgery. By applying pressure on the scar by wearing a pressure garment or device, this can help prevent the scar from reforming. The second is the use of injections after surgery. After the surgery, your dermatologist may inject you with the aforementioned corticosteroids or interferon. This combination of injections and surgery seems to be the most effective way to treat raised scars. After the surgery, most patients receive their injections once a month over a period of a few months. The third is the use of radiation after the surgery. Although this may seem a bit dangerous to some under controlled circumstances, radiation has been shown to be able to be used to prevent raised scars from returning after the surgery.
There is an increase of dermatologists using lasers to treat raised scars. The two main laser-based therapies are known as Pulsed Dye Laser (PDL) and Intense Pulsed Light (IPL). They are both equally effective at treating raised scars. These treatments help reduce the itching and pain that accompany raised scars, as well as diminish the reddish color and flatten out the raised scar. The Intense Pulsed Light is mostly used for those with a lighter skin tone than others. After the laser-based therapies, dermatologists will also use corticosteroid injections or pressure as an added treatment.
Dermatologists may also use a lesser known treatment called cryotherapy. Cryotherapy involves freezing the scar tissue which causes it to die and gradually fall off over a period of time. To obtain better results, the dermatologist may schedule a series of cryotherapy sessions along with the combination of corticosteroid injections as well. These can effectively diminish the hypertrophic and flatten raised scars. The one downside to cryotherapy is that it can leave the treated skin looking lighter than the surrounding skin which limits its use to people with certain skin colors and skin tones.
There are different types of gels, creams and tapes that can be used to help treat raised scars at home without the need of a prescription. There are a few products that contain silicone that can help reduce the itch and discomfort of hypertrophic scars. There are scientific studies that found that using a silicone gel continuously for six month can noticeably flatten scars. Your dermatologist may also prescribe certain medication such as tretinoin. This is mainly a medication to treat acne but can also be used on raised scars to help reduce the itching and pain. Your dermatologist may also prescribe a rather powerful corticosteroid. It can have the same result as if you get the corticosteroid injections in that it improves the look of the scar and helps stop the pain. To be most effective, any of the gels, creams and tapes that may be used, should be used on a regular basis. It is also important to note that these are not substitutes for the different therapies used to treat hypertrophic scars, although they can be used to help reduce the size and discomfort of the raised scars. Oral antibiotics may also be prescribed as an extra level added to help treat raised scars.
Since raised scars are difficult to treat and heal, researchers are continuing to search for better treatments. There have been a few other treatments that have been studied to have some effect on raised scars.
5-Flourouracil (5-FU): This is an experimental injection that has been shown to be effective to reduce hypertrophic scars. It has also been shown to respond better when combined with the corticosteroid injections, instead of using either of them separately.
Imiquimod: This is a type of cream that is mainly used to treat certain skin cancers and genital warts. There was a study that showed that when this cream was applied after surgery, that was a reduced reappearance of raised scars. Unfortunately, these finding seems to be inconclusive because there was another study that seemed to contradict these same results.
Radiation Therapy (By Itself): Dermatologists have been finding that radiation therapy alone can effectively treat raised scars. However, it seems to be most effective for raised scars that have been on the skin for less than five months.
It is always best to talk to your dermatologist about the best courses of action when it comes to finding the best and right way to treat your hypertrophic and other raised scars. As with everything else medical related, you should never do anything without consulting them first to make sure it is safe. A lot of these procedures may or may not work on everyone as we all have different skin tones and sensitivity. Unfortunately, there is really no surefire way to prevent hypertrophic scars from forming. Even though there is no prevention, there are still plenty of ways to help treat raised scars. Every day, there are specialists that are finding new and safer ways to treat and get rid of hypertrophic raised scars. With all this experimentation, it is only a matter of time before they find a single way to get rid of these scars permanently and prevent them from returning.