Hypertrophic Scars: What are, Causes, Prevention, and Effective Treatment Options
Hypertrophic scar formation are a common issue many people face after surgery or injury. These scars tend to be raised and appear thicker than usual, giving the skin a bumpy texture. Sometimes called overgrown scars, they form when the body produces too much tissue while healing. This extra tissue makes the hypertrophic scar feel harder and more noticeable. Red and raised, these scars and keloids can linger for months or even years after the skin has closed. They are often referred to as thick healing marks, making them not only a cosmetic concern but also something that may affect your skin's appearance and feel long-term.
Keloid and Hypertrophic scars formation are a common concern for individuals healing from surgery or injury. They are characterized by an overgrowth of scar tissue that remains within the original wound boundaries but rises above the surrounding skin. In this article, we’ll explore the nature of hypertrophic scars and keloids, how they develop, and most importantly, how we can help you improve their appearance at Natalia Mejia Skin.
What are the Hypertrophic Scars?
A hypertrophic scar occurs when the body produces excess collagen during the wound-healing process, causing the hypertrophic scar to become raised, red, and firm. Unlike keloids and hypertrophic scars, which extend beyond the boundaries of the original wound, keloids and hypertrophic scars remain confined but can still cause aesthetic and, sometimes, physical discomfort.
This type of scar typically forms once the wound has closed and continues to develop for “6 to 12 months” after the injury or surgery, potentially lasting up to 2 years. Several factors may influence the formation of keloids and hypertrophic scars, including age, anatomical location, the origin of the wound, and the presence of infections during the healing process. When a wound becomes infected, it increases inflammation, leading to more collagen production and a higher likelihood of developing hypertrophic scarring.
Characteristics of Hypertrophic Scars
Hypertrophic scars present several defining characteristics that set them apart. These include:
Raised Texture: These scars are typically thicker and raised compared to the surrounding skin.
Color Variation: The coloration often ranges from pink to red or purple, depending on blood flow and healing.
Localized Growth: Unlike keloids, hypertrophic scars remain confined to the site of the original injury without spreading.
Potential Symptomatology: They may be itchy or tender, causing discomfort, particularly in areas subjected to movement.
Maturation Process: Over time, scars tend to flatten and fade but may take months to years to do so.
What Causes Hypertrophic Scars?
Hypertrophic scars form when the skin overproduces collagen during the healing process after an injury, surgery, or trauma. This excessive collagen buildup often results from prolonged inflammation, tension on the wound, or improper wound care. Factors such as genetics, the location of the wound, and infections can also contribute to their development. Unlike keloids and hypertrophic scars remain confined to the original wound area but can appear raised, red, and thick. Understanding these causes is essential for preventing their formation and implementing effective treatment options.
Differences Between Hypertrophic and Keloid Scars
Hypertrophic scars are often confused with keloid scars due to their similar appearances. However, they possess distinct differences that are essential to understand:
Growth and Appearance
Wound Boundaries: Hypertrophic scars do not grow outside the initial wound area, while keloids extend beyond it.
Surface Texture: Hypertrophic scars are raised but tend to have a more textured surface compared to keloids, which are often smoother.
Causes and Development
Causative Factors: The formation of scars is primarily driven by an abnormal healing response characterized by excess collagen production.
Inflammation Impact: Hypertrophic scars may arise from wounds that experience inflammatory complications, whereas keloids are generally associated with an overactive healing response to injury.
Time of Appearance: Hypertrophic scars typically develop weeks to months after the injury, while keloids may take longer, sometimes manifesting years after the triggering event.
Causes and Risk Factors
The development of hypertrophic scars is influenced by various factors that can lead to their formation. Understanding these causes and risk factors is crucial for both prevention and management.
Collagen Overproduction
One of the primary contributors to hypertrophic scar development is the overproduction of collagen. Collagen is a protein key to the healing process, but in some individuals, fibroblasts can produce excessive amounts. This abnormal healing response creates thickened, raised tissue. The reasons behind this overproduction are not fully understood, although it may be linked to individual biological variations.
Tension on the Wound
The mechanical tension applied to a wound site plays a significant role in hypertrophic scar formation. Areas of the body where skin is subjected to stretching or movement are especially susceptible. For instance, injuries located near joints, such as elbows or knees, may develop hypertrophic scars more readily due to the constant movement that strains the healing tissue. Minimizing tension through protective measures can help reduce this risk.
Infection and Inflammation
Infections can complicate wound healing and increase the likelihood of hypertrophic scarring. When a wound becomes infected, the body responds with inflammation, which can disrupt normal healing and lead to excessive collagen formation. Signs of infection may include redness, warmth, swelling, and discharge. Proper wound care to prevent infection is essential to minimizing inflammation and subsequent scarring.
Delayed Healing
Wounds that heal slowly often result in a higher risk of developing hypertrophic scars. Factors contributing to delayed healing include:
Chronic illnesses such as diabetes or vascular diseases that impair circulation.
Nutritional deficiencies, especially a lack of proteins or vitamins necessary for healing.
Improper care or handling of the wound, which can also complicate the healing process.
Addressing these factors is vital for promoting effective healing and minimizing scar formation.
Genetic Predisposition
Genetics may also contribute to an individual's likelihood of developing hypertrophic scars. People with a family history of raised scars or keloids generally have a higher risk of forming hypertrophic scars themselves. Understanding one's genetic background can inform preventive strategies and treatment decisions.
FAQs About Hypertrophic Scars Formation
Hypertrophic scars often prompt common questions regarding their nature, progression, and management. The following sections address frequently asked questions to provide clarity and understanding about this skin condition.
Do Hypertrophic Scars Go Away?
Hypertrophic scars have the potential to improve over time. It is common for these scars to become less pronounced as they mature, often flattening and reducing in color. Generally, this process can take several months to a couple of years. However, the rate of improvement varies among individuals.
The natural regression of hypertrophic scars occurs due to a decrease in collagen production and changes in the skin's structure. While many people see a significant reduction in the scar’s appearance, some may find that their scars remain noticeable. Factors influencing this include:
Type of injury that caused the scar.
Extent of collagen overproduction at the site.
Personal skin type and healing ability.
Age and overall health of the individual.
In cases where hypertrophic scars do not improve adequately or cause discomfort, medical treatment options may be pursued to help alleviate symptoms and enhance appearance.
Can Hypertrophic Scars Be Prevented?
Preventing is possible with proper care during the wound healing process. Although complete prevention may not be achievable for everyone, specific strategies can significantly reduce the risk of developing these scars after an injury.
Key preventive measures include:
Proper Wound Care: Keeping the wound clean and protected is crucial. This minimizes the risk of infection, which can worsen scarring.
Minimizing Tension on the Wound: Employing techniques to limit pressure or movement around the wound area reduces strain, which may contribute to abnormal scar formation.
Using Pressure Garments: After surgical procedures or significant injuries, wearing pressure garments can aid in flattening the scar as it heals.
Individual Awareness: Understanding personal risk factors, especially for those with a history of hypertrophic scarring, encourages proactive wound management.
These strategies can help individuals reduce the likelihood of developing hypertrophic scars, contributing to better aesthetic and functional outcomes following injuries.
Prevent Hypertrophic and Keloid Scars
While the development of hypertrophic scars is not always avoidable, several preventative measures can help minimize their severity:
Gentle Massaging Techniques
Applying gentle massage techniques can help reduce adhesions and improve the mobility of the skin once the inflammation has subsided. It’s important to adapt the massage intensity to the stage of inflammation. Massages that are too intense may worsen the scar or cause discomfort, and infection is a contraindication for massage therapy.
Skin Mobilization
Skin mobilization can help decrease the tension on a scar. This involves gently stretching the skin around the scar using your fingers, which can help improve the flexibility and appearance of the scar. This technique should be performed once the inflammation has reduced to avoid further irritation.
Reducing Tension with Adhesive Strips
Tension on the skin can lead to hypertrophic scarring. To prevent this, using adhesive strips or Steristrips after suture removal can help reduce tension on the scar. This approach limits the tension that might otherwise cause excessive collagen production. Keeping the wound supported in this way during the first year of healing can significantly improve scar outcomes.
Sun Protection
Excessive exposure to the sun’s rays can cause scars formation to darken due to increased melanin production. Applying sunscreen to the scar, even after it has healed, is crucial in minimizing discoloration and keeping the hypertrophic scar from becoming more noticeable.
Hydration and Moisture Retention
Using moisturizers and occlusive dressings can help retain moisture in the skin, which is especially beneficial for itchy scars. Hydrating products like mineral oils, fatty acids, silicone oils, and wax esters can preserve skin moisture and soften the scar tissue. Ingredients like urea and lactic acid can also help condition and soften the skin, reducing abnormal scar tissue formation.
How We hypertrophic scar treatments at Natalia Mejia Skin
We offer specialized treatments designed to reduce the appearance of scars by improving the scar's color and texture. Our approach includes:
Specialized Needling: We use a precise needling technique at the appropriate depth to stimulate collagen production and encourage skin regeneration. This technique helps flatten raised scars and improve their overall appearance.
Regenerative Cells: We combine needling with regenerative cell treatments to enhance the natural healing process and further improve the texture of the hypertrophic scar.
Peels: Various chemical and organic peels are used in conjunction with needling and regenerative therapies to reduce inflammation and help even out the color of the scar. These peels work to smooth the skin and promote the development of healthier skin tissue.
We aim to provide a comprehensive, non-invasive approach to scar improvement, helping you feel confident in your skin again with a scar camouflage tattoo. While understanding hypertrophic scars and their treatment options is crucial for those seeking relief, many individuals find that traditional scar revision treatments aren't enough to achieve the aesthetic results they desire. For those looking to take the next step in their scar transformation journey, paramedical tattooing offers a revolutionary solution. Natalia Mejia, a renowned NYC scar specialist, provides camouflage tattoo procedures that can effectively blend scars with surrounding skin tone, dramatically improving appearance and restoring confidence. Discover how paramedical tattooing can transform your hypertrophic scars and other skin concerns by exploring our comprehensive guide to cosmetic tattoo for scars.
Hypertrophic scars can be challenging, but they are manageable with the proper care and treatment. At Natalia Mejia SKIN in NYC, we specialize in helping clients improve their scars through tailored treatments that address the color and texture. If you want to treating for hypertrophic scars and reduce the appearance of a keloid and hypertrophic scar, we invite you to contact us for a scar camouflage tattoo consultation. Together, we’ll develop a personalized treatment plan to meet your specific needs and help you achieve the best possible results.