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What is Hypertrophic scar?
Written by Medicover Team and Medically Reviewed by Dr Rajitha Alluri , Dermatologist
A hypertrophic scar is a thick, raised area of skin that forms at the site of a wound. It develops when the body produces too much collagen during healing. These scars stay within the boundary of the original injury and often occur after burns, surgery, or trauma, especially on tight or high-motion areas like shoulders or joints.
What are the Hypertrophic Scar Symptoms and Warning Signs?
Hypertrophic scars usually appear within weeks of skin injury and can cause both visible and physical discomfort. Early detection helps in timely treatment.
Common Symptoms
- Raised, firm scar over the wound site
- Pink, red, or darkened skin tone
- Mild itching or discomfort
Severe Symptoms
- Tightness or pulling sensation in the scar area
- Painful or irritated skin
- Restricted movement if scar forms near joints
What are the Types of Hypertrophic Scar?
There are no distinct clinical types, but hypertrophic scars may vary in appearance and severity depending on the cause and location. They are often categorized based on the type of wound:
- Post-burn hypertrophic scars common after deep burns
- Surgical hypertrophic scars often occur when wound edges are under tension
- Traumatic hypertrophic scars result from injuries like cuts or abrasions
What's the Difference between Hypertrophic Scar and Keloid Scar?
One major difference between hypertrophic scars and keloids lies in how far they spread from the original injury. Hypertrophic scars remain limited to the exact area of the wound, growing upward but not outward. In contrast, keloid scars extend beyond the wound edges, often invading nearby healthy skin.
| Feature | Hypertrophic Scar | Keloid Scar |
|---|---|---|
| Growth pattern | Stays within the original wound area | Grows beyond the original wound area |
| Time to develop | Forms within weeks after injury | It can appear months or even a year later |
| Color | Pink or red | Red, purple, or dark brown |
| Common locations | Areas under skin tension (e.g., shoulders, joints) | Chest, shoulders, ears, cheeks |
| Chance of fading | May flatten and fade over time | Rarely improves without treatment |
| Treatment response | Usually responds well to therapy | Often difficult to treat; high chance of return |
| Cancer risk | Very rare | Slightly higher in long-standing cases |
What are the Common Causes and Risk Factors of Hypertrophic Scar?
Hypertrophic scars result from abnormal healing in deeper skin injuries. Some people are more prone than others due to skin type, wound type, or genetic traits.
Causes
- Excess collagen production during wound healing
- Deep burns or surgical incisions
- Skin trauma or infections during healing
Risk Factors
- Darker skin tones (more common in African and Asian descent)
- Genetic predisposition to raised scarring
- Tension or stress on healing skin (e.g., joints, chest)
- Delayed healing or wound infections
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Get Second OpinionHow is Hypertrophic Scar Diagnosed?
Diagnosing a hypertrophic scar usually begins with a physical exam and review of your medical history. Doctors look closely at how the scar feels, looks, and how long it has been present. In some cases, further testing like dermatoscopy or a biopsy may be done to confirm the diagnosis.
Common diagnostic steps include
- Clinical inspection and medical history
- Dermatoscopic exam to assess skin thickness
In rare cases, a skin biopsy may be done to rule out keloid or other conditions
What are the Treatment Options for Hypertrophic Scar?
Treatment focuses on making the scar flatter, softer, and less noticeable. Options range from simple silicone sheets to advanced injections or laser therapy. The best approach depends on the size, location, and response of the scar to previous treatments.
Here are some treatments that can help
- Steroid shots: They flatten the scar and lower swelling.
- Laser therapy: It lightens the scar and makes the skin smoother.
- Silicone sheets or gels: Use them every day to shrink the scar and ease discomfort.
- Cryotherapy: This uses cold to freeze and slowly shrink the scar.
- Medicated injections (5-FU or bleomycin): Used for resistant scars
- Surgery (only in severe cases): usually combined with other therapies to prevent recurrence
When to See a Doctor?
If your scar is painful, keeps growing, or affects how you move, it's time to see a doctor. Early care can help flatten the scar and prevent long-term problems.
It's important to seek medical advice if:
- The scar keeps growing or becomes painful
- You notice tightness that limits movement
- Over-the-counter creams don't help after months
- You've had similar raised scars in the past
High-risk individuals, such as those with burn injuries, a family history of keloids, or healing complications, should consult a specialist early.
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What is the Recovery Process After Hypertrophic Scar Treatment?
Recovery takes time, and results are usually gradual over several months. You'll likely need follow-ups and at-home care, such as silicone gel or avoiding sun exposure.
Post-treatment recovery includes
- Regular follow-up visits (every 4 to 6 weeks for injections or lasers)
- Using silicone products as advised
- Avoiding sun exposure to prevent darkening
- Staying hydrated and maintaining good skin hygiene
The long-term outlook is positive, and most scars fade and flatten over 6 to 18 months, especially with consistent treatment.
What Precautions Can Help Prevent Hypertrophic Scar?
Smart wound care during healing can prevent hypertrophic scarring. This includes keeping wounds moist, using silicone gel early, and following all post-procedure instructions. Early attention makes a big difference, especially for people at higher risk.
Prevention Tips
- Keep wounds clean and moist during healing
- Avoid pulling or stretching healing skin
- Use silicone gel or sheets early in wound recovery
- Follow your doctor's post-surgical instructions
- Treat infections quickly to avoid delayed healing
What Can Happen If a Hypertrophic Scar is Not Treated?
Without treatment, a hypertrophic scar may become thicker, darker, or more uncomfortable. It can also cause stiffness if located near a joint or lead to emotional stress due to appearance. Treating it early helps avoid long-term issues and improves skin health.
- Ongoing pain or itching
- The scar is becoming thicker or darker over time
- Trouble moving if the scar is near a joint
- Feeling upset or self-conscious about how the scar looks
Our Experience in Treating Hypertrophic Scar
At Medicover, we treat hypertrophic scars with care and advanced techniques. Our team of skin experts, surgeons, and laser specialists work together to reduce pain, improve movement, and restore healthy-looking skin.
Every treatment plan is made just for you because we want you to heal well and feel confident in your skin.again. Your skin's recovery is our priority from the first visit to long-term care.
