Hypertrophic scar
| Hypertrophic scar | |
|---|---|
 | |
| Hypertrophic scar (4 months after incident) | |
| Specialty | Dermatology |
A hypertrophic scar is a
Cause
Mechanical tension on a wound has been identified as a leading cause for hypertrophic scar formation.[3]
When a normal wound heals, the body produces new collagen fibers at a rate which balances the breakdown of old collagen. Hypertrophic scars are red to brown and thick and may be itchy or painful. They do not extend beyond the boundary of the original wound, but may continue to thicken for up to six months. Hypertrophic scars usually improve over one or two years, but may cause distress due to their appearance or the intensity of the itching; they can also restrict movement if they are located close to a joint.[citation needed][dubious ]
Some people have an inherited tendency to hypertrophic scarring, for example, those with Ehlers–Danlos syndrome.[citation needed]
Prevention
It is not possible to completely prevent hypertrophic scars, so those with a history of them should inform their doctor or surgeon if they need surgery. Pressure garment therapy is a commonly used approach used to try and prevent hypertrophic scarring, for example, after a burn, however, the effectiveness of this approach is not clear.[4]
Management
Early hypertrophic scars should be treated with applied pressure and massage in the first 1.5–3 months.[5] If necessary, silicone therapy should be applied later. Ongoing hypertrophy may be treated with corticosteroids injections.[5] Surgical revision may be considered after 1 year.[6]
Silicone gel sheeting
Silicone gel sheeting is sometimes used to treat hypertrophic scars. Silicone gel sheets may improve the appearance of scars slightly compared with applying onion extract, and may reduce pain compared with no treatment with silicone gel sheets or pressure garments.[7] It is uncertain whether silicone gel sheets are more effective than other treatment approaches.[7]
Laser therapy
Laser therapy is an approach that has been studied for treating hypertrophic scars.[8] There is not enough evidence to determine if laser therapy is more effective than other treatments or if laser therapy leads to more harm than benefits compared with no treatment or different kinds of treatment.[8]
Cryosurgery
Cryosurgery, using extreme cold to remove dead tissue, may speed up the healing process from a hypertrophic scar to a flatter, paler one.[9][needs update]
See also
- List of cutaneous conditions
References
- ISBN 978-1-4160-2999-1.
- ISBN 978-3-7091-0348-7.
- PMID 38189494.
- ^ PMID 19621835.
- S2CID 260136591.
- ^ PMID 34564840.
- ^ PMID 36161591.
- PMID 8363398.