Laser therapy is often used to treat hypertrophic scars caused by burns. Laser therapy not only improves the color of the hypertrophic scar but can reduce the height of the scar and tension on the scar. Laser therapy can also relieve symptoms such as pain and pruritus.
Steroid Injections
Dermatologists may inject a corticosteroid solution directly into a hypertrophic scar or keloid, which may help reduce its size. Steroids break the bonds between collagen fibers, which reduces the amount of scar tissue beneath the skin.
Unlike keloid scars, hypertrophic scars do not extend beyond the boundary of the original wound. They may continue to thicken for up to 6 months before gradually improving over a few years.
The resulting hypertrophic scar can be raised, red, uncomfortable, and potentially limit movement. Though they generally flatten out and resolve within weeks to months, hypertrophic scars that cause pain or limit movement can benefit from treatment.
Hypertrophic scars are usually raised, although rarely elevated more than 4 mm above the skin; red or pink in color; hard; and pruritic. Additionally, these scars do not extend beyond the general geographic margins of the wound and tend to regress over time.
Research has shown that gently massaging a scar may break down scar tissue as it forms. It may also prevent hypertrophic scars or keloids from developing after an injury.
A hypertrophic scar will often regress completely between 6 months and 3 years after it first appears. Around 75 percent of people with hypertrophic scars said their biggest concern was how the scar appeared, rather than how it affected their health.
Hypertrophic scars usually start to develop within weeks after the injury to the skin. Hypertrophic scars may improve naturally, although this process may take up to a year or more. In treating hypertrophic scars, steroids may be the first line of therapy with this type of scar, although there is not one simple cure.
A hypertrophic scar can itch and be painful, and are uniform without extending past the original incision or wound. They do not drain any pus, and often have dry skin flaking off them.
However, there are three distinct stages to healing and your scar will have a different appearance during each stage. The three phases to healing are the inflammatory stage, the proliferative stage and the remodelling stage.
Keloids and hypertrophic scars are caused by cutaneous injury and irritation, including trauma, insect bite, burn, surgery, vaccination, skin piercing, acne, folliculitis, chicken pox, and herpes zoster infection.
Hypertrophic scars are contained within the site of injury and may regress over time, while keloids spread beyond the borders of the initial injury and do not regress.
Hypertrophic scars remain limited to the traumatized area and regress spontaneously within 12-24 months, although regression may not necessarily be complete.
It is never too late to receive a scar tissue release massage. You may just need a couple of sessions to feel confident and comfortable to do this on yourself at home.
Among 10 patients with hypertrophic burn scars who underwent treatment with fractional CO2 laser therapy, VSS, POSAS score, and quality of life measures all showed significant improvement within 6 months of treatment. Strikingly, scar firmness was observed to decrease by 30% after a single session.
Collagen is the most abundant protein of the extracellular matrix and excessive deposition has been implicated in the formation of hypertrophic scar. Collagen types I and III have both been shown to increase in hypertrophic scar compared to other subtypes [33] with a concomitant decrease in collagenase production [34].
Most of the time red or reddish-purple scars will fade in color as the wound heals, which typically takes around 12 months. In some cases, however, scars can remain discolored. This occurs most frequently with keloids and hypertrophic scars.
Scar massage is a way of softening and flattening scars. It can stop scar tissue build up and help make scars less noticeable.
Use Vaseline® Jelly for Scars
By sealing in moisture it also helps to reduce dryness of scarred skin, once your skin has healed. This may help to improve the appearance of scars, making the skin look smoother and softer, as well as help to reduce itchiness caused by dryness.
If a patient massages their scar prematurely it could cause the wound to tear or reopen, risking an infection. It's therefore important to advise them to not begin massaging until the wound is fully healed.
Silicone can help reduce the appearance of new scars, though it may not improve the appearance of old scars. Doctors have used silicone sheeting for over 35 years , and silicone gel is also now in use. Evidence seems to suggest that these options are effective at reducing scars and improving their appearance.