Hypertrophic Scar vs. Atrophic Scar: What’s the Difference and How Can We Help?
Scars are a natural part of healing. But not all scars heal the same way — and not all scars look the same.
Some scars are raised and thick. Others are sunken and uneven. And many clients who come to Natalia Mejia Skin feel confused or discouraged about what kind of scar they have — or why it isn’t improving with time or creams.
Understanding the difference between a hypertrophic scar and an atrophic scar is the first step to choosing the right treatment. Because how a scar looks is often a reflection of what’s happening beneath the surface of the skin.
Let’s talk about:
What each scar type is
Why they form
How to recognize them
What can be done to improve them
And how we gently support your healing journey at Natalia Mejia Skin in NYC
What Is a Hypertrophic Scar?
A hypertrophic scar is a raised, thickened scar that forms when your body produces too much collagen during healing.
Your skin’s natural repair process creates collagen to close the wound. But in some cases — due to inflammation, tension, or genetic factors — your skin produces more than needed, causing the scar to grow upward and become firm or rubbery.
✧ How It Looks
Raised and thick
May be red, pink, brown, or dark depending on skin tone
Often stays within the original wound boundary
May feel firm, itchy, or tight
Common in surgical scars like tummy tucks, breast lifts, or C-sections
To explore options to reduce this type of scar, learn more about our scar revision and camouflage treatments.
What Is an Atrophic Scar?
An atrophic scar is the opposite: it forms when your skin doesn’t produce enough collagen during healing. This results in a sunken or indented scar, because the tissue underneath wasn’t fully rebuilt.
These scars can look like small dips, hollows, or even holes in the skin.
✧ How It Looks
Flat or depressed
Thin or wrinkled texture
May look lighter than surrounding skin
Appears as pits or uneven surface
Common with acne scars, chickenpox, or healed stretch marks
Some stretch marks can also fall under the atrophic category. For those cases, our stretch mark camouflage and regeneration protocol may be ideal.
Why Do These Scars Form So Differently?
It all comes down to collagen balance.
Hypertrophic scars = too much collagen
Atrophic scars = not enough collagen
Many factors can affect this healing balance, including:
Your skin type and tone
Your genetic background
The type of injury or surgery
How much inflammation or tension was present
Whether the skin was supported with hydration and protection during healing
Even the same person can develop different types of scars on different parts of their body.
How to Tell the Difference
If you’re not sure what kind of scar you have, ask yourself:
Does the scar feel raised and firm? → Likely hypertrophic
Does the scar feel sunken or hollow? → Likely atrophic
Is it red, pink, or pigmented? → Could be either, depending on your skin tone
Does it feel tight, itchy, or stretched? → More common with hypertrophic
Does it look like a dent or uneven dip? → More common with atrophic
At Natalia Mejia Skin, we assess every scar individually — sometimes scars are a combination of both, or have shifted over time.
Can Topical Creams or Oils Help?
Topicals may help reduce inflammation, soothe the skin, or hydrate the surface — but they often can’t reach deep enough to correct the structure of the scar.
Especially for:
Atrophic scars, which require deeper collagen stimulation
Hypertrophic scars, which may need physical remodeling or resurfacing
That’s why we use regenerative techniques that address both the surface and deeper layers of the skin.
How We Treat Hypertrophic Scars at Natalia Mejia Skin
Our approach always starts with regeneration — because pushing pigment or pressure on a raised scar can make it worse.
We often use:
✨ Microneedling with regenerative serums to remodel thick tissue
🌿 Peels and hydration treatments to soften texture and calm pigment
⚡ Plasma or light therapy for deep cellular repair
🎨 Scar camouflage tattooing — only once the scar is flat and stable
How We Treat Atrophic Scars at Natalia Mejia Skin
For atrophic scars, the goal is to stimulate collagen production and rebuild lost volume.
We focus on:
✨ Microneedling with collagen-boosting serums
💧 Hydration therapies to plump the skin
🌿 Peels to smooth the surface and fade discoloration
💎 In some cases, camouflage tattooing can help even out tone once the skin is more stable
What If I Have Both Types of Scars?
It’s very common!
A tummy tuck scar may have a raised area near the incision (hypertrophic) and a hollow indentation in the center (atrophic).
A stretch mark may appear sunken, but the edges are thickened from inflammation.
A post-acne scar may be a mix of textures, requiring different layers of care.
At Natalia Mejia Skin, we create a tailored plan that treats both patterns at the same time — honoring the skin’s complexity and restoring balance.
How Many Sessions Will I Need?
That depends on:
The age and depth of the scar
Your skin type and tone
The area of the body
How the scar responds to the first few treatments
On average:
Most clients begin to see visible changes within 2–4 sessions
Milder cases may improve significantly in 6 sessions
More complex or older scars may take 8–18 sessions
We adjust the plan based on progress, always putting your skin’s rhythm first.
Why Choose Natalia Mejia Skin?
Because we don’t just treat scars. We treat people.
At Natalia Mejia Skin, you’ll receive:
🌿 Gentle, regeneration-first care
🎨 Custom treatment plans for your specific scar type
💛 A warm, non-judgmental space where you are seen and respected
🧬 The latest scar revision techniques — backed by real results
✨ Emotional support as you reconnect with your body
Whether your scar is from surgery, acne, trauma, or pregnancy — we will walk this journey together.
And if your scar is part of your breast reconstruction story, we also offer 3D areola tattooing as a restorative complement to your healing.
Whether your scar rises above the skin or sinks below it, it tells a story.
It deserves to be understood. And you deserve to feel good in your skin again.
Hypertrophic scars. Atrophic scars. New scars. Old scars.
They can all be softened, improved, and lovingly cared for.
Let’s help your skin heal — not just on the surface, but at its core.
With heart,
Natalia Mejia
Scar Specialist & Paramedical Tattoo Artist in NYC
✨ Scar Regeneration • Camouflage • Confidence Restored