Hypertrophic scars are abnormally raised and thickened scars that develop when a wound site heals under too much tension. In some cases, formation of these types of scars on your skin can cause significant movement restrictions in nearby tissues and structures. If this occurs, your doctor may recommend partial removal of the affected skin.
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Hypertrophic scars are similar to other forms of raised scars, called keloids, which most commonly occur in individuals with dark skin color, according to the American Osteopathic College of Dermatology. However, hypertrophic scars form more frequently than keloids and can occur regardless of your skin color. In most cases, hypertrophic scars flatten out naturally over time, the New Zealand Dermatological Society reports. However, if scars of this type form in the aftermath of major skin loss, you may develop a condition called contracture, which occurs when scar formation limits normal range of motion in your nearby joints, tendons or muscles.
If you develop contracture as a result of hypertrophic scarring, your doctor may recommend a surgical procedure called a Z-plasty. During Z-plasty, the surgeon will remove some of your scar tissue with a series of precise, small incisions around the scar site; when these new incisions heal, they alter the way in which your remaining scar sits on your surrounding skin. The overall effect is a reduction in the size of your hypertrophic scar, improved mobility and better blending between the appearance of your scar and your normal skin.
Recovery time for hypertrophic scar surgery varies with the location and extent of the procedure you receive. In most cases, you can return to normal work and home activities after only a short period. During your recovery, your doctor may ask you to strictly avoid any task or activity that directly stretches or otherwise disturbs the healing scar. If hypertrophic scarring has caused chronic stiffening in an associated joint, you may also require physical therapy to return that joint’s full range of motion.
Pulsed Dye Lasers
Your doctor can use a device called a pulsed dye laser to flatten your hypertrophic scars. During a pulsed dye laser session, high-energy yellow light is used to alter the shape of the scar tissue; the procedure can also reduce or eliminate burning or itching symptoms associated with your scar. In most cases, you will need to undergo pulsed dye laser therapy two or more times every two months to maintain the flattening effects of treatment.
Your doctor may also be able to reduce the appearance of a hypertrophic scar with silicone-containing creams, gels or bandages. Be aware that no procedure can entirely remove a scar from your skin or restore your skin to its pre-injured appearance. Consult your doctor or scar specialist for more information.