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Hypertrophic scars appear as thick, red scarring due to an injury or other damage to the skin. These types of scars are sometimes confused with keloid scars because both types are similar in shape and size. Keloid scars tend to grow outside of the immediately affected area, however. Hypertrophic scars usually restrain their size and growth to only the immediate affected area.
Hypertrophic scars also tend to heal themselves, decreasing in size and irritability over time, usually a 12-18 month period. The scars will not disappear entirely, however.
Hypertrophic scars are similar to keloid scarring in that they share a commonality in causality. Both occur due to surgery, injections, body piercing, acne or some trauma to the skin. Both types of scars can also be caused by skin surgery, or other restorative surgical procedures involving the skin.
Unlike keloid scarring, there seems to be no relationship to ethnic or family history associated with hypertrophic scars. Collagen levels in both keloid and hypertrophic appear to be similar in bulk, much more than in normal scar tissue. Hypertrophic scars are most likely to appear on the breastbone, ears, and shoulders, but may occur anywhere on the body.
In terms of healing, hypertrophic scars tend to heal themselves, decreasing in pain and swelling over a period of time (usually about a year or more). The healing process may be aided and hastened with the help of steroid topical ointments or steroid injections. Further steroid injections will help the scar recover faster.
Hypertrophic scar revision and surgery utilizing a type of excision or atraumatic closure with a reorientation using Z-plasty or the like often produces quick and detectable results. This surgical excision is the most prescribed method of surgically aiding hypertrophic scarring. Further hypertrophic scarring may occur, however, as a side effect of the surgery.
In all cases, dicuss your options thoroughly and only with a board certified plastic surgeon. Only after weighing your options and going through minor testing can a successful approach to combating hypertrophic scarring take place.