The excessive healing of a wound can be annoying aesthetically, but it can be located in areas that make mobility difficult or generate itching or burning. Both hypertrophic and keloid scars are formed by excessive skin growth that is trying to heal itself.
If you want to know more about the treatment options, which one is best, and when they are used, then we invite you to continue reading this FastlyHealarticle on how to remove hypertrophic scars.
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What are hypertrophic scars?
To understand what a hypertrophic scar is, it is essential to know what normal scarring is. After the skin has been injured, different stages of its healing ensue: first, the scar is reddish, then it increases a little in size and, finally, it flattens and takes on a similar color to the rest of the skin, which begins to occur after about seven months. The whole process typically ends about one year later.
Healing will be more difficult in different situations:
- There are areas of the body where it is more complex, such as the back of the chest.
- Fertile women (postmenopausal and men heal better).
- Contaminated wound.
- Large wound.
- Family predisposition.
In these circumstances, some people may suffer pathological or poor scarring, which can be flawed due to excess tissue (excessive scarring) or short scar; it does not cover the scar. Wound. Hypertrophic scars and keloids are the forms that excessive scarring can take. A scar cannot be said to be pathological until six months after the injury occurred; until then, only its worsening can be prevented.
Hypertrophic scars are characterized by:
- Please stay within the limits of the usual spot; maybe it can be a little bit wider.
- It is not usually raised.
- It remains reddish.
- Show up early, immediately after the injury occurred.
- Being able to improve over time.
- Be located anywhere on the skin.
- Caused by tension on the skin or because the healing process lasted longer than usual.
- Occur in both men and women of any age.
All this allows it to be differentiated from a keloid type scar, in which:
- Exceeds the edges of the original wound.
- It constantly grows after a time of surgery, trauma, burn, etc., and does so for several years.
- It does not get better on its own with time.
- It is usually located on the face, ears, and chest.
- It is not known why it is caused; it has been seen that it can happen in members of the same family.
- It is more common in women, predominantly Asian and dark-skinned.
- It happens more in people between 10 and 30 years of age.
Although the treatment is similar, it is different from each other. Below you will find information on how to treat a hypertrophic scar.
How to remove hypertrophic scars: treatment
As seen in the previous section, Hypertrophic scars have a better chance of improving with treatment. There are many different treatments, and all of them try to make the spot look more ordinary; that is, their objectives are: that the scar is flat, foldable (that has mobility) and that its color is similar to that of the surrounding skin.
Many studies try to determine which is the best option to remove hypertrophic scars; the conclusion is that the combination of different treatment methods usually gives the best results.
Up to 6 months after the injury occurred, the scar can be prevented from continuing to grow or darken. After six months, it can be said that the scar is pathological and a treatment can be established.
Prevention options include:
- Application of creams that reduce tissue proliferation.
- Compression by placing silicone, hypoallergenic tape or elastic bands.
When the scar has already become hypertrophic and is raised, the way to remove it or reduce its size is by:
- Corticosteroid injection: as the first therapeutic measure.
- Cream application.
- Compression (silicone, tape or elastic bands).
- Laser reshaping.
- Radiation therapy (very rare).
Hypertrophic scar creams
The creams used in the treatment of a hypertrophic scar contain corticosteroids as the main element . There are two that are the most used:
- Clobetasol cream : it is a very powerful corticosteroid, which is also used to treat other skin diseases such as psoriasis .
- Cream with triiodothyronine and flumethasone : the first is similar to thyroid hormones, the second is a corticosteroid.
Your doctor will choose one or the other (or perhaps neither) depending on the appearance of the scar, the cause of it, if you are pregnant or if you have any disease.
These creams are applied daily on the scar, not for a very long time because they can have adverse reactions such as:
- Cutaneous atrophy (it is very thin and not very vital).
- Changes in skin color.
- Suppression of the adrenal glands.
Silicone for hypertrophic scars
Silicone is widely used to improve hypertrophic scars, both for prevention and treatment. Not only does it compress them, but this material also helps to prevent them from growing . The ideal is to place it when the area to be treated has a reddish color to make it more effective.
The silicone comes in two presentations: in gel or in plates, some are self-adhesive for the areas of the skin where it is difficult to hold them (such as the chest or the back).
The important thing in this treatment is perseverance; they should be used throughout the day (about 18 hours) and, then, you should rest at night to avoid what is known as the rebound effect, that is, to worsen the healing. When they are removed, the indicated cream can be applied for the best result.
They should be used until the scar takes the color of the skin, that is, until it is no longer red.
Treatment for hypertrophic scars by compression
This is another good way to tighten scars, also while they are red, then it no longer works. This pressure that it exerts must be controlled, since if it is excessive, it can generate more damage. They can be used: hypoallergenic adhesive tapes or elastic bands , all depending on the area where the scar is. It is used for the same number of hours as silicone.
Corticosteroid injection for hypertrophic scars
It is one of the most used techniques, the injected medication is usually triamcinolone . It can be used after surgery (to prevent excessive scarring in someone with the possibility of having it) or to reduce the size and discomfort of a hypertrophic scar.
It is always applied only to the scar, since the surrounding skin must be taken care of, which can atrophy (have less vitality, lose weight, disappear the fat in the area). There are different forms of application in terms of the interval between applications; there are those who suggest applying it weekly at the beginning and then once a month, there are others who do it every month or 40 days, it depends on medical criteria.
Another injectable medication used in the treatment to remove keloid scars is 5 fluorouracil , a chemotherapy drug that is often used if corticosteroids have not been sufficient.
Hypertrophic scar laser
It is another way to remove hypertrophic scars; it is reserved for cases in which it is not improved with other less invasive techniques.
There are different types of laser, the one that showed the best results is the ultra-pulsed light that improves the elasticity of the skin, reduces the height of the scar and, above all, improves itching.
Surgery to remove hypertrophic scars
In very large, very complex hypertrophic scars or that do not respond to other treatments, surgery is sometimes used: they are removed and, usually, a corticosteroid is placed and compressed, all of this to prevent it from occurring again . It is done only in adults.
Radiation therapy to treat hypertrophic scars
It is not usually a common indication in hypertrophic scars, only for those very severe and that have not improved with other treatments, rather in keloid-type scars.
This article is merely informative, at FastlyHeal .com we do not have the power to prescribe medical treatments or make any type of diagnosis. We invite you to see a doctor in the case of presenting any type of condition or discomfort.
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I am a Surgeon with a diploma in comprehensive ultrasound and surgical care residency, an area I am specializing in. During the exercise of my profession, I have realized the need for patients to know the diseases they suffer, and I can tell you that a large part of their complications is due to a lack of information. Being a health web writer allows me to transmit my experience, without borders, to all those readers eager for knowledge, educate them in the prevention of diseases and promote a healthy lifestyle.