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. Covering a scar for 4-5 months with either silicone or non-silicone gel may be helpful in reducing the size and color.
According to many laser experts, 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. Data shows that the earlier the treatment of the scar, the better the result.
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