Are your scars getting thicker and more raised? Let's talk about Hypertrophic Scars!

Have you ever had an injury somewhere, and after it healed, the scar that remained was a little bumpy, thick, and sometimes red? Sometimes you might feel a little itchy or painful because of this scar. It's normal for anyone to feel a little scared and worried when they see something like this. You might think, "Oh, what is this?", "Is this something dangerous?" But don't be afraid. Most of the time, this is due to a condition called Hypertrophic Scar . Today, we'll talk about this very simply, in a way that you can understand.

Simply put, what is Hypertrophic Scar?

To understand this, let's first look at how a wound heals. If a small scratch occurs on the top layer of our skin, it will heal without leaving a big scar. But if the wound is a little deeper, that is, if it goes all the way down to the ``dermis`` layer of the skin, our body uses something special to heal that wound. That is collagen .

Collagen is a type of protein found in our skin. The body makes new collagen to heal a wound. This new tissue is slightly thicker than normal skin. Most of the time, scars that form this way are flat, level with the skin.

However, sometimes our body's wound healing process goes a little too far. Then the body produces more collagen than it needs . This extra collagen accumulates at the site of the wound, causing the scar to bulge out of the skin and become thicker. This is what we call a hypertrophic scar. The important thing is that this scar only forms within the original wound .

What is the difference between a Hypertrophic Scar and a Keloid Scar?

Many people get confused about the two terms hypertrophic scars and keloid scars. Although both are raised scars, there are clear differences between the two. Imagine you have a small wound on your hand that has healed.

• If it is a hypertrophic scar, the scar only forms within the area where the wound was. It does not spread beyond that area.
• A keloid scar is like a mushroom growing, growing beyond the original wound and spreading to surrounding healthy skin.

See the table below to understand this difference more clearly.

Are these scars dangerous?

Not at all. This is the best news I can give you.

These are mainly cosmetic problems . However, sometimes these scars can cause a little pain and itching. Also, if a scar like this develops on a joint like an elbow or knee, it can be difficult to bend and straighten that joint properly, which means it can interfere with movement . In such cases, it is important to get treatment.

What are the characteristics of a hypertrophic scar?

These scars are not that difficult to identify. Look for these signs after your wound has healed.

• The skin where the wound was is thickened and looks raised .
• The color of the scar may be pink, red, or purple .
• This scar begins to fade within a month or two after the injury.
• The scar may be itchy, painful, or tender to the touch .
• These are most commonly seen on the chest, back, shoulders, and upper arms . They can also be seen around the joints.
• If it forms over a joint, it can interfere with the movement of that joint .

What are the treatments for this?

The main goals of treating a hypertrophic scar are to flatten the scar, soften it, reduce its size, reduce discoloration, and relieve discomfort such as pain and itching.

In many cases, your doctor, especially a dermatologist or plastic surgeon, will wait several months, perhaps even a year, before starting treatment. This is because hypertrophic scars tend to flatten and shrink over time. If they don't, treatment is the only option.

Here are some of the main treatment methods.

Medical Treatments

• Corticosteroid injections: This is the main treatment. These injections are injected directly into the scar. This breaks down the extra collagen tissue in the scar, flattening and softening the scar. It also reduces pain and itching. You may need to get several injections, every few weeks.
• Laser therapy: Special types of lasers (`Pulsed dye lasers`, `Nd:YAG lasers`) are used to target the blood vessels in the scar. This stops the growth of the scar, reduces redness, and reduces its thickness. Some laser methods create small holes in the scar, softening it and helping it to reshape.
• Other types of injections: Drugs called `(Bleomycin)` or `(5-FU)` are injected directly into the scar. These flatten the scar and reduce pain and itching.
• Cryotherapy: A method of flattening scars by slowly destroying scar tissue using extreme cold (such as liquid nitrogen).
• Surgery: Only if other treatments are unsuccessful, surgery is performed to remove the scar. However, this is considered a last resort, as surgery can cause the scar to recur.

Self-Care Options

• Silicone gel sheets: Once the wound has healed, these silicone gel sheets or ointments can be used daily on the scar. These should be used continuously throughout the day for several months. This is said to help reduce the size, redness, thickness, and itching of the scar.
• Apply moisture and pressure: Apply a non-sticky pad, such as petroleum jelly, to the scar and secure with tape. Then apply slight pressure with an elastic wrap or ACE bandage, which has been shown in some studies to reduce scarring.

How to prevent scarring and properly care for an injury?

The best way to prevent hypertrophic scars is to take proper care of the wound from the beginning. If you have a cut after surgery or any other wound, follow your doctor's instructions carefully.

Here are some general things to keep in mind:

• Keep the wound clean: Wash the wound with soap and water. Never use hydrogen peroxide. It can further damage the skin.
• Keep the wound moist: Do not let the wound dry out until it heals. Apply petroleum jelly (like Vaseline) or a similar ointment. This will greatly reduce the risk of scarring.
• Change the bandage daily: Change the bandage daily or as often as needed, as directed by the doctor.
• Protect yourself from the sun: After the wound heals, be sure to wear a good sunscreen with an SPF of 30 or higher when going outside on the scar. Sun exposure can cause the scar to darken even more.
• Tell your doctor about a tendency to scar: If you have had previous injuries that caused these types of scars, tell your doctor about it before any surgery so he or she can pay special attention to it.

In conclusion, a hypertrophic scar is nothing to be afraid of. However, if it is affecting your appearance or interfering with your daily activities, you should definitely see a doctor to discuss the best treatment for it.

Hypertrophic scar Sinhala, wound scars, keloid scars, keloid scar vs hypertrophic, scar treatment, wound healing Sinhala, skin diseases