Hypertrophic scars are thick, broad, and frequently elevated marks that develop at sites of skin injury. Treatment approaches range from clinical procedures to at-home care, with the choice depending on how quickly you wish to reduce their appearance.
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About Hypertrophic Scars | Treatment Methods | Clinical Treatments | Home Care | Hypertrophic vs. Keloid Differences | Preventive Measures
Understanding hypertrophic scars
Hypertrophic scars are dense, wide, frequently raised marks that emerge following skin trauma. While scarring is a normal healing response, hypertrophic scars represent an irregular reaction to injury.
Some individuals, based on skin characteristics or healing patterns, may generate excessive collagen during recovery. Contributing factors include infections, inflammation, wound tension, or leaving injuries unclosed, all potentially leading to collagen overproduction and hypertrophic scarring.
These scars frequently appear after burns but may also result from piercings, lacerations, or acne lesions. Though resembling keloids, hypertrophic scars typically stay confined to the initial injury site.
While not medically dangerous, hypertrophic scars can cause itching, discomfort, or aesthetic concerns. Treatment possibilities include topical applications, silicone products, steroid injections, or laser procedures to minimize scar visibility and symptoms.
Treatment approaches for hypertrophic scars
Healthcare providers may recommend multiple therapies to flatten and diminish scar appearance.
Recognize that scar maturation is a gradual process—potentially lasting a year. During this time, your body naturally refines scar tissue. Consequently, medical professionals frequently suggest waiting several months to a year before treating emerging hypertrophic scars.
Clinical treatment options
Corticosteroid therapy: Steroid injections serve as a frontline treatment for hypertrophic scars. Administered every six weeks, these injections can flatten and soften scars, though excessive use may weaken adjacent tissue.
Laser treatment: Most beneficial for recent scars, laser therapy burns and flattens raised scars while addressing discoloration to lighten their appearance.
Bleomycin injections: Direct scar injections with Bleomycin show potential for improving appearance and alleviating symptoms like itching and pain, though more research is required.
Cryotherapy: Liquid nitrogen freezing effectively flattens hypertrophic scars, with studies demonstrating its safety and patient tolerance.
Surgical removal: After allowing at least one year for scar maturation, surgical excision with proper wound closure can eliminate hypertrophic scars while addressing contributing factors like infection or tension.
At-home care methods
Silicone products: Silicone sheets represent a noninvasive, commonly recommended treatment. Available as sheets, gels, sprays, or foams, they’re applied daily for several months.
Pressure therapy and massage: Cost-effective scar management involves applying pressure and massaging the area. Bandages or tape can gradually soften scar tissue and enhance appearance.
Onion extract products: OTC gels containing onion extract (e.g., Mederma) exist, though clinical evidence supporting their efficacy remains limited.
Bio Oil: While popular for scar treatment, Bio Oil requires more extensive clinical testing to confirm its effectiveness against hypertrophic scars. It’s widely available at beauty retailers.
For help locating a primary care physician, consider using our FindCare tool.
Distinguishing hypertrophic from keloid scars
Before treating a hypertrophic scar, proper differentiation from keloids is essential, as treatment strategies differ. Keloids are firm, smooth, benign growths resulting from excessive scar tissue proliferation.
Hypertrophic scars typically:
- Raise less than 4mm above skin level
- Appear red or pink
- Can form anywhere on the body
Keloids generally:
- Extend more than 4mm above skin
- Grow beyond original wound margins
- Display pink to purple coloring
- Progressively enlarge
- Commonly affect earlobes, shoulders, cheeks, and upper chest
Both scar types occur more frequently in darker skin tones. While hypertrophic scars respond better to treatment, keloids often recur despite intervention.
Preventing hypertrophic scarring
Following injuries, particularly burns or surgical procedures, these measures may help prevent hypertrophic scarring:
- Maintain proper wound hygiene and use dressings to prevent infection
- Consider post-surgical silicone sheeting, proven effective in scar prevention
- Discuss preventive steroid injections with your healthcare provider post-surgery
Preliminary research indicates that immediate burn cooling with cold compresses and tea tree oil application might promote improved healing and potentially prevent hypertrophic scars, though additional studies are necessary.
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About Hypertrophic Scars | Treatment Methods | Clinical Treatments | Home Care | Hypertrophic vs. Keloid Differences | Preventive Measures