Hypertrophic Scars

Hypertrophic scars are raised, firm, scars formed as the result of an overproduction of collagen during the healing process. They are usually pink-red in color, and are limited to the site of original trauma. Over time, they may regress. Scar formation is a necessary part of the healing of skin tissue after an injury. However, abnormal or disturbed collagen production can cause poor restoration of the cutaneous surface and textural irregularities. There are various factors that determine how your skin will scar, including depth and size of the wound, heredity, ethnicity and age. These scars can be produced by minor trauma and are frequently found on the upper chest, upper back and shoulders (and areas where acne commonly occurs). Although scars are harmless, they are more susceptible to environmental factors such as sun damage.

Hypertrophic scars can be easily identified by their firm and raised appearance. They are usually pink or red in color.

Hypertrophic scars are caused by trauma to the skin such as cuts, punctures or burns. As the skin undergoes the natural healing process and repairs itself, scar tissue is formed. Cells in the dermis (fibroblasts) produce collagen in excess, which is the reason that these scars are raised and unnecessarily thick. Unlike keloid scars they do not grow outwards and away from the site of trauma.

Some scar tissue may become sensitive, so it’s important to exercise proper skin care. Choose gentle cleansers for the skin, preferably in liquid form. These cleansers will gently remove dirt, excess oil, bacteria and cosmetics without irritating the skin. Avoid soaps, especially bar soaps, as they will often cause dry skin. When bathing, avoid scrubbing the skin too hard. This can also cause irritation to scar tissue. After washing, gently pat the skin dry with a towel.Moisturizers help to restore and maintain the skin’s natural moisture levels. Look for a moisturizer specially designed for sensitive skin that is free of fragrance, dye or other allergens that may irritate the skin.

Sun damage can be minimized to the skin and scar tissue by following these simple tips.

Limit sun exposure:Reducing your time in the sun is perhaps the easiest way to avoid damage to your skin caused by UV rays. When outdoors, set a time limit and seek shade when necessary. Also keep in mind that UV radiation is the strongest between the hours of 10 a.m. to 4 p.m.

Use Sunscreen: Sunscreens are an essential part of protection against the sun. Look for sunscreens that are labeled “Broad Spectrum”. They are often the most effective and offer protection against both UVA and UVB rays. Make sure to apply generously and frequently.

Cover and protect: Wrap-around sunglasses, wide-brimmed hats and clothing that covers your arms and legs, can offer extra protection against the sun’s harmful UV rays.

OTC
Skin camouflaging cosmetics can cover up the appearance of scars.

Prescription
A doctor may administer Kenalog and 5-fluorouracil injections to treat hypertrophic scars. Topical imiquimod applied to the healing site after surgery has shown to improve excessive scarring.

Procedures
Progress in laser technology and refinements in technique have made laser therapy a preferred treatment choice for hypertrophic scars. Pulsed dye lasers (PDL) have shown to be very effective in treating scars with minimal side-effects and discomfort.Hypertrophic scars can also be removed by shave excision. The scar is tangentially shaved with a flexible razor blade/scalpel until it is level with the surrounding skin avoiding entry into the deep dermis. There is risk of bigger regrowth of the scar.