No, hypertrophic scars generally cannot be completely removed to look like normal skin, but they can be significantly improved and made much less noticeable with treatments like silicone sheets, steroid injections, laser therapy, massage, pressure, or surgical revision, often using combination approaches for best results. The goal is to flatten, soften, and fade the scar, making it blend better with surrounding skin, rather than achieving perfect invisibility.
Normal Scar. While hypertrophic scars and keloids both result from excessive collagen production, they behave quite differently. A hypertrophic scar remains within the original wound boundaries and often improves spontaneously over 1–2 years, though it rarely returns to completely normal skin.
Hypertrophic scar treatment
These scars may also be removed surgically. Often, steroid injections are used along with the surgery and may continue up to 2 years after the surgery to help maximize healing and decrease the chance of the scar returning.
Topical silicone gel – Topical silicone gel sheeting is a new and painless method to treat hypertrophic and keloid scars. Although the actual mode of action is unknown, it is hypothesised that it could be due to hydration of the skin from the silicone stimulates new collagen production.
A hypertrophic scar is a thick raised scar that's an abnormal response to wound healing. They more commonly occur in taut skin areas following skin trauma, burns or surgical incisions. Treatments include medication, freezing, injections, lasers and surgery.
About hypertrophic scars
They may be painful or itchy. They do not extend beyond the boundary of the original wound, but may continue to thicken for up to 6 months. Hypertrophic scars usually improve within 12 to 24 months and generally fade and flatten over time.
Laser technologies have significantly changed how we approach hypertrophic scar treatment. These procedures break down scar tissue so it can heal in a smoother, flatter, and more comfortable pattern while improving the appearance of the skin.
Raised (hypertrophic): You can feel a hypertrophic scar when you run your finger over it. These raised scars may get smaller over time, but they never completely flatten out. Unlike keloids, they don't grow or spread beyond the wounded area.
Scars form when the skin heals after a wound, and hypertrophic scars can result when excessive collagen builds up during the healing process. Microneedling activates the skin's repair mechanism, promoting the production of new collagen and resulting in smoother, more pliable skin.
In general, two or more laser sessions are needed to treat hypertrophic and keloid scars in order to obtain the desired degree of scar flattening and color lightening (Table 3).
Hypertrophic scars are particularly prevalent among adult burn patients, with those with darker skin, younger age, female sex, burns greater than 20% of total body surface area (TBSA), and burns on the neck and upper limbs experiencing the highest risk [6,8].
Your scar should gradually soften and fade over these six to 18 months, but will look pink initially (photo B). Some scars never fade. If your scar stays pink after 12 to 18 months please call to discuss options. If your scar becomes raised and rubbery instead of flat, this could be an abnormal scar process (photo C).
Hypertrophic scars are thick, red to brown in coloration, and may be itchy or painful. They do not extend beyond the boundary of the original wound but may continue to rise or thicken for up to six months. Hypertrophic scars usually heal and fade over one to two years.
Scar creams and silicone sheeting begins at $75. Laser treatments start at $200 per treatment depending on the size of the scar and texture. Dermal fillers begin at $700 per syringe.
Topical silicon gel is safe and effective treatment for hypertrophic and keloidal scars. It is easy to apply and cosmetically acceptable.
Ice Pick Scars: Deep, narrow, pitted scars—usually the most difficult to treat. Boxcar Scars: Round or oval depressions with sharp edges that appear shallow. Rolling Scars: Wavy depressions that create an uneven skin surface. Keloid and Hypertrophic Scars: Raised scars from excessive collagen production during healing.
This type of scar stays within the border of the original wound. Keloid scars represent a more robust scar response with the formation of firm raised tissue outside the border of the original wound. Hypertrophic scars can regress and become less pigmented and flatter over the course of several months to over 1 year.
While hypertrophic scars themselves won't completely disappear, they often improve significantly, even without treatment, becoming less noticeable and flatter. This process can take weeks to months, depending on the size and location of the scar.
Bio-Oil focuses on deep hydration and moisturization, making it ideal for scar management. associated with post-surgical scars, as well as common scars like hypertrophic or keloid.
To ensure full coverage, a more heavyweight foundation is recommended. Similar to atrophic scars, hypertrophic scars require texture correction to see a noticeable difference. In this case, we would want to apply a texture-filling product around the raised areas to minimize the disparity in surface level.
Smoking and Nicotine Use Severely Impair Wound Healing
Smokers are up to 10 times more likely to develop problematic scars, including thick, raised keloids and hypertrophic scars. Even secondhand smoke, nicotine patches, and e-cigarettes can interfere with the healing process.
What Is Laser Therapy? Laser therapy is a revolutionary approach to treating scars, utilizing focused light energy to target and repair damaged skin. By penetrating deep into the dermis, lasers stimulate collagen remodeling and promote skin resurfacing.
A hypertrophic scar may develop as part of the skin's response to injury and is a reddish, itchy, firm, normally raised, thicker-than-usual form of scar that's similar in color and texture to normal skin. They do not get bigger over time and may get better in 12-24 months without treatment.