By Gary M. White, MD

Hypertrophic Scar

A hypertrophic scar is the elevated and excessive growth of fibrous tissue within but not extending beyond the bounds of a scar is characteristic. Keloids by definition extend beyond the area of injury.


A thickened, raised scar is seen. There is no epidermal change. The thickening is dermal. The lesion is usually red.


Patients must have realistic expectations. "Once a scar always a scar." But the appearance can be improved. If treatment is needed, intralesional triamcinolone (10-40 mg/cc Q month) may be injected (see keloids). Some hypertrophic scars have persistent telangiectasias and/or erythema. The flash-pumped dye laser may be tried for these lesions [Derm Surg 1995;21;685]. Covering a scar for 4-5 months with either silicone or non-silicone gel may be helpful in reducing the size and color [Derm Surg 2001;27;721].


According to some experts [e.g. Jill S Waibel MD Miami], almost any scar--burn, traumatic, acne etc.--can be improved with laser therapy. For example pulsed dye laser or IPL are used for erythematous scars and fractional or CO2 laser for thickened scars.


The following are recommended to minimize scar formation after surgery.

Although scar massage is anecdotally effective, there is scarce scientific data in the literature to support it [Dermatol Surg. 2012 Mar;38(3):414-23].

There is a growing body of evidence that either intraoperative or peri-operative interventions can minimize scar formation [JAMA Derm 2015;815]. For example, intraoperative fractional carbon dioxide lasers for sutured wounds and manual dermabrasion for second-intention wounds are advocated. One study of botulinum toxin to prevent the formation of thyroidectomy scars showed compelling results [Wound Repair Regen. 2014;22:605-612.].

Additional Pictures

Hypertrophic scars after bilateral otoplasty.
Hypertrophic Scar Hypertrophic Scar

Hypertrophic Scar


Homepage | FAQs | Use of Images | Contact Dr. White

It is not the intention of RegionalDerm.com to provide specific medical advice, diagnosis or treatment. RegionalDerm.com only intends to provide users with information regarding various medical conditions for educational purposes and will not provide specific medical advice. Information on RegionalDerm.com is not intended as a substitute for seeking medical treatment and you should always seek the advice of a qualified healthcare provider for diagnosis and for answers to your individual questions. Information contained on RegionalDerm.com should never cause you to disregard professional medical advice or delay seeking treatment. If you live in the United States and believe you are having a medical emergency call 911 immediately.