Hypertrophic Scars and Keloids
Not all scars are flat or depressed; some can grow into large bumps, and these can sometimes be larger than the original wound. These scars are known as hypertrophic scars, and can be genetically linked.
Treatment options exist, but recurrence of such scars are common, so treatment might be a long-term affair.
What Are Hypertrophic Scars?
Unlike atrophic scars where healing is poor and results in depressed tissue with poor quality skin, hypertrophic scarring results from an overly enthusiastic healing response, resulting in excessive amounts of collagen and scar tissue deposition. This results in a raised, unsightly scar. If the scar is the same size as the original wound that resulted in the scar, it is termed a hypertrophic scar; if the scar extends beyond the boundaries of the original wound, it is known as a Keloid.
Can Anything Be Done?
Treatment options are available, but the recurrence rate is typically high. Even surgical removal is not permanent, with reccurence of up to 50% of patients who have undergone surgical removal of the scar.
Minimally invasive and even home-based procedures like the following can help reduce the size and appearance of such scars:
- Intralesional steroid injections: A first-line treatment performed at 4 to 6 weekly intervals, these steroid injections help to shrink the size of hypertrophic scars after several sessions.
- Botox injections: Botox can be applied to the scar to reduce the tension across the wound; this tension is theoretically a contributing factor the hypertrophic scar formation, so reducing this tension potentially reduces the chance of scar growth or recurrence.
- Silicon sheet or gel: Also considered a first-line modality for hypertrophic scars, this simple-to-apply technique involves the application of a silicone sheet or gel for 12 to 24 hours per day over 2 to 3 months.
- Massage and pressure therapy: A well studied, cheap and effective means of reducing hypertrophic scar tissue, massaging effectively helps weaken scar tissue and improve the appearance of the scar over time.
- Lumecca IPL.: Targetting the vascular component in new keloids, IPL helps prevent further growth of newly formed hypertrophic scars.