What you should know about hypertrophic scars
When physical injuries damage skin tissues, the resultant wound heals with scar tissues forming at the site of former injury. Wound healing is a repair – substitute tissue by scar – process not tissue regeneration – subsitute tissue by the same tissue).
Typically, scars can be crimson in color and grow and slightly raised. But in some cases, the wound can develop into a hypertrophic scar. These are thick and purple growths that keep building over the skin level, even after it has completely healed. This blog looks at how these scars can be treated and decreased in appearance.
What are hypertrophic scars?
Hypertrophic scars occur in the case of a lot of hysteria around a healing wound. Those scars are thick and raised and frequently pink. They will remain like this for several years.
Hypertrophic scars result from an imbalance in collagen on the wound’s surface.
Characteristics of hypertrophic scars include:
- Forming within the boundaries of the original wound site
- Creating thicker healing tissue
- Being red and raised initially, becoming flat and pale over time
- Lack of souplesse, and therefore restricting movement
Treatments for hypertrophic scars
Often, hypertrophic scars settle over time on their own, but some treatments can help the process. There are various simple, conservative therapy options to influence scar maturation, these are summarized in the so-called scar suppression ladder.
Basic skin Care
The quality of the skin has an important influence on the scarring. Therefore is is important to keep the skin moistures and remove any irritation at the site of scar and around the scar.
Goals of the scar massage done by the patient himself 3-5x7day are:
- Desensibilization (reduction of hypersensitivity)
- Reduction of scar volume
- Reduction of scar redness
- Mobilization of the sca by removal of scar adhesions
It is important to stress, that the massage is the important thing, not the ointment” . therefore simple and cheap Vaseline or any fatty creme have the same effect than expensive so-called “scar cremes”.
Pressure dressings are especially useful in cases where wounds take more than 10 to 14 days to heal or after skin grafting. Compression-Therapy on a scar leads to a so-called “beneficial ischemia”. Depending on the amount of pressure there is:
– Acceleration of scar maturation, if > 15 mmHG
– Reduction of scar volume, if > 25 mmHG
Silicone gel sheets
Silicone gel sheeting has been treating potential hypertrophic scars since the early 80s.
This treatment is easy and budget-friendly at the very early stage of scar development. Pads are positioned immediately at the scar for 8 – 20 hours daily for 6-12 months. Application of a thick silicone sheet on a scar has an occlusive effect and leads to a local increase of temperature and water steam, which are thought to be the main responsible changing that:
- Reduce scar redness
- Improve scar souplesse
It has been claimed that high-pressure, elastic dressings can reduce the formation of hypertrophic scars by between 75- 85%.
Combined Silicone gel sheets & Compression
Combined application of both treatments not only leads to addition of both effect but to potentiation of the individual effects, an therefore is the treatment of choice.
Cortisone injections into the hypertrophic scar
Cortisone or steroid injections are the primary-line remedies for keloids and other hypertrophic scars. The injections are repeated every 6 weeks. There scar area should be well anesthetized, as the treatment is very painful without local anesthesia.
Between 80-90% of people observe an improvement after cortisone injections, and frequently hypertrophic scars will fade after this remedy.
Crytherapy may be an alternative to cortisone injection. This is the combination of liquid nitrogen with steroid injections. It is effective for keloids but is used for some cases of hypertrophic scars.
There are different types of LASER treatments, depending on the light used for the treatment. Main indication are treatment of redness (Erbium LASER) and scar ablation (CO2-LASER). Several treatments with an interval of 6 weeks between are necessary.
If after all conservative treatments, the scar still shows hypertrophy, surgery is indicated, that is after 9 – 12 months at its erliest. However, scar removal surgery dubai may be an earlier option if the hypertrophic scars impede movement due to being at a joint or causing excessive tension in the surrounding tissue.
Prevention of hypertrophic scars
Studies indicate that hypertrophic scars are commonplace after burn accidents, with 39% of reported hypertrophic scars following a bur (hypertrophic scar plate) . Hypertrophic linear scars can also follow many injuries, including unintended trauma, piercings, and surgical procedures.
Keeping off unnecessary pores and skin surgical operations will restrict the hazard of having a hypertrophic scar, as the incidence rate after a surgical procedure is around forty to 94%. For treatment and consultation of hypertrophic scars, book an appointment with Prof Dr Robert Hierner.