woman showing scar on arm

Hypertrophic scars: Causes and Treatments

How to prevent scarring as a part of the result of the wound healing process and reduce the appearance of hypertrophic scars.
Many people have developed a scar after one of life’s unfortunate events, like surgery, a car accident or another type of injury. After a skin injury has occurred, scarring is a natural part of the healing process. Only wounds that do not affect the dermis can heal without scars. Hypertrophic scars raise above the surrounding skin level and may continue to thicken for up to six months, but are limited to the original wound area.

What are hypertrophic scars?

A hypertrophic scar is a result of an abnormal response to an injury or skin trauma. Scar tissue forms as wounds heal, which usually becomes flat and pale. However if there is a lot of tension on a healing wound, the area becomes raised and thickened, leading to what is known as a hypertrophic scar


Hypertrophic scars appear red and raised, sometimes remaining like this for several years. They are characterised by an excess of collagen which is caused by a dysregulated healing process.

Medical cutaway illustration of a hypertrophic scar

Hypertrophic scar vs keloid

Like keloids, hypertrophic scars develop as a result of excess collagen being produced at the site of a wound, although more collagen is produced for keloid scars. Whereas keloid scars extend beyond the boundary of the original wound, hypertrophic scars do not, and tend to be easier to treat.


In general, hypertrophic scars are rarely more than four milimetres above the skin, tend to be pink or red and can grow anywhere on the body. In comparison, keloids can raise to more than four millimetres and can be red, purple or darker than surrounding skin. These are usually located on the shoulders, upper chest, cheeks or earlobes (especially after piercings).

What causes hypertrophic scars?

As mentioned, hypertrophic scars are the result of an imbalance of collagen at the site of a wound. They are a common complication of burn injuries, with research suggesting that between 30 and 91 percent of burns result in a hypertrophic scar. They also tend to develop after piercings, cuts or sometimes acne and chickenpox.


While they affect men and women from any racial group equally, those aged between 10 and 30 are more at risk. It is believed that the elasticity in younger skin leads to a higher production of collagen.

Symptoms of hypertrophic scars

Hypertrophic scars aren't life-threatening or contagious, but they can cause cosmetic or body confidence issues. Here are some common symptoms:

  • slight itching where the scar meets normal skin
  • some pain in the centre
  • restricted movement as the skin is no longer as flexible
  • eventually becoming paler and flatter
  • gradually flattening out over time
 
illustration of a hypertrophic scar
Medical illustration of a hypertrophic scar
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How to reduce the risk of scarring

Scars are formed in the last phase of wound healing, and the scar's appearance will depend on how successfully the wound has healed. In order to reduce the risk of unsightly scars and ensure a safe and fast healing, it is recommended to follow some basic wound care principles:
  1. Wound cleansing: As infections may increase the risk of abnormal scarring, always make sure that the wound is properly cleansed from particles, dirt and bacteria. Use the Elastoplast Wound Spray to cleanse the wound fast and easily.
  2. Wound protection: Make sure the wound is covered with an appropriate plaster or sterile wound dressing from Elastoplast. This will protect the wound from germs and bacteria which might enter the wound, delay wound healing and possibly cause wound infection.
  3. Moist wound healing: To reduce the risk of scarring and support a faster wound healing, experts recommend moist healing conditions. Apply the Elastoplast Wound Healing Ointment to create optimal healing conditions and support a fast wound healing with reduced risk of scarring.
Elastoplast Wound Spray

Tips to prevent scars from forming

  • Protect wounds and newly formed scars from the sun rays.
  • Do not expose wounds and newly formed scars to extreme temperatures.
  • Avoid exercises or activities that cause tension to the scar tissue.
  • Only have stitches removed when suitable, because taking them out too early or delaying the process can interfere with wound healing.
  • Avoid deliberate cuts or breaks in the skin like tattoos or piercings, especially on the earlobes.
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How to flatten hypertrophic scars

We often seek to reduce or hide the appearance of scars, as they’re perceived as unsightly and can impact quality of life. Individuals may suffer from psychological impairment and reduced self-confidence, as well as the physical discomfort. For this reason, someone may want to reduce a scar, especially if it’s located on a visible part of the body.

For scar treatment, use Elastoplast Scar Reducer Patches to reduce the visibility of raised and coloured scars, while making them flatter, softer and lighter. These discreet, transparent scar reducer patches are made of flexible and breathable material.


These discreet, transparent scar reducer patches are made of flexible and breathable material. They are a safe and efficient way to effectively reduce raised and coloured hypertrophic scars, with first results noticeable after three or four weeks.

Elastoplast scar reducer plasters

Hypertrophic scar treatment

There are a number of treatment options available for hypertrophic scar removal, and these scars tend to be easier to treat than keloids. Speak to your doctor if a hypertrophic scar is causing you discomfort.

Corticosteroid injections are regarded as the most effective treatment for hypertrophic scars. Injecting a steroid into the scar every six weeks can help to soften the scar and flatten its appearance. This can only be  performed a certain number of times, because these injections could weaken the normal tissue surrounding the scar. Between 50 and 100 percent of people notice an improvement with this treatment, and sometimes the scars fade completely, but there is a small recurrence rate.

Surgery is not usually required, because hypertrophic scars tend to increase in size for the first three to six months before starting to regress. However, if the scar is causing excessive tension or impeding movement it can be excised.

Laser therapy uses high beams of light to resurface the scar and reduce the red or pink pigments. However, this does not make the scar any smaller and there's a risk this can actually increase scarring. This is more effective in newly formed scars than in older scars.

Cryosurgery, which involves freezing early scars with liquid nitrogen to prevent them from growing, is another effective hypertrophic scar treatment. Other treatment options include silicone gel, pressure dressings, emollients, corticosteroid injections, oral or topical tranilast (to inhibit collagen synthesis) and skin needling.
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