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.
Adolescents and pregnant women may be more likely to form hypertrophic scars. People with darker skin complexions are about 15% more likely to develop keloid scars, and the lowest incidence of hypertrophic scars is in persons with albinism.
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.
Hypertrophic scars can develop when excess tension pulls at a wound closure, after a burn, or after other types of skin injury. This type of scar can occur anywhere on the body. It begins to appear about eight weeks after injury and can occur in men and women of all ages.
Keloids are more likely to occur in areas of the body associated with a high level of muscle tension. In the head and neck, the earlobe and mandibular border are most commonly affected. The high recurrence rate of keloids has initiated a wide variety of different treatment approaches.
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.
Factors that increase the risk of hypertrophic scarring include: Burn wounds, especially second- and third-degree burns. Systemic (whole body) inflammation. Poor wound healing due to infection.
Massaging your scars is important. It keeps the tissue around the incision loose so it doesn't “stick” to the tissue underneath. Wait until after your skin has healed before you start massaging your scar. Your skin will be healed when the edges of the scar are well closed with no gaps, and have no drainage.
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.
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.
Hypertrophic scars and keloids may be itchy, tender, or painful. These unusual scars may occur as a result of genetics—they sometimes run in families, and typically, if one forms after an injury, it forms after your subsequent injuries, too. But why they form in some people and not others isn't known.
Keloid disease and hypertrophic scars are dermal tumors that are often familial and typically occur in certain races.
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.
Bio-Oil helps to improve the appearance of new or old scars; whether from surgery, accidents, burns, insect bites, scratches or conditions such as acne or chickenpox. Although younger scars will have a greater chance of improvement, studies have shown that older scars also benefit from regular use of Bio-Oil.
Silicone gels or sheets can be used on healing skin (not open wounds) to help soften and flatten a scar. They can also relieve itching and discomfort. To be effective, silicone gels or sheets should be placed over the scar for 12 hours a day for at least 3 months. They can be washed and reused.
One tip for taking care of scars is to use a topical ointment. Cocoa butter cream and Vaseline are most often used to help reduce the appearance of scars. Applying the ointment daily will help heal scars but will not make them invisible.
In vitro studies have demonstrated that retinoids can modulate collagen production and the proliferation of normal and keloidal fibroblasts. In vivo applications of 0.05% topical retinoic acid can lead to a reduction of hypertrophic scars in 50-100% of patients and of keloids in less than 20% of patients.
HYPERGRANULATION TISSUE + HYPERTROPHIC SCARRING
It is important to be aware that hypergranulation tissue / hypertrophic scars are NOT something to be popped, and that motion (playing, poking, twisting and turning) is the major cause.
Apple Cider Vinegar
It prevents scar-promoting cells from entering the keloid site and also reduces both pigmentation and size of the keloids. It also soothes the irritated skin and reduces any swelling. Dilute the ACV with a little water and dab it on the keloid using a cotton ball.
The result of fractionated CO2 laser resurfacing can significantly improve the appearance of the treated skin with raised hypertrophic scars making them more uniform. Patients especially appreciate the laser's ability to safely treat not only facial skin, but also other areas of the body.