Wound healing is divided into three phases (inflammatory, proliferative, remodeling). The scar is formed in the last phase (remodeling phase). There are increased numbers of myofibroblasts in hypertrophic scars.
The three phases to healing are the inflammatory stage, the proliferative stage and the remodelling stage.
A hypertrophic scar will often regress completely between 6 months and 3 years after it first appears.
The signs and symptoms of a hypertrophic scar are easy to recognize. They include: Hard or thickened raised tissue over your wound site. Pink to red to purple skin color over your wound site.
There are three distinct, sequential phases of repair leading to the formation of a fibrotic scar: (1) inflammation, (2) new tissue formation, and (3) remodeling.
Wound healing is classically divided into 4 stages: (A) hemostasis, (B) inflammation, (C) proliferation, and (D) remodeling. Each stage is characterized by key molecular and cellular events and is coordinated by a host of secreted factors that are recognized and released by the cells of the wounding response.
The complicated mechanism of wound healing occurs in four phases: hemostasis, inflammation, proliferation, and remodeling.
Hypertrophic scars are usually raised, although rarely elevated more than 4 mm above the skin; red or pink in color; hard; and pruritic. Additionally, these scars do not extend beyond the general geographic margins of the wound and tend to regress over time.
Hypertrophic scars develop in 1 to 2 months after injury, whereas, keloids develop months to years after the initial injury. Hypertrophic scars and keloids often cause irritation, pruritus, and even neuropathic pain. Severe hypertrophic scars or keloids over a large area can cause contractures that may be disabling.
Unlike keloid scars, hypertrophic scars do not extend beyond the boundary of the original wound. They may continue to thicken for up to 6 months before gradually improving over a few years.
Dermatologists may inject a corticosteroid solution directly into a hypertrophic scar or keloid, which may help reduce its size. Steroids break the bonds between collagen fibers, which reduces the amount of scar tissue beneath the skin.
Scar tissue may become hard and raised. Massage can help to soften and flatten the scar tissue. Scar tissue may stick to the underlying muscles, tendons, blood vessels, nerves and bones. Massage can prevent this from happening and helps to keep the scar tissue flexible.
Cortisone injections.
These types of injections can help soften and then shrink hard scars. Keloids and hypertrophic scars often soften after intralesional steroid injections.
Scars take time to settle. The lumpiness, puckering and thickening in the scar take 2-3 months to diminish, whilst the redness and pigmentation can take up to 9-12 months to fade. Most scars become flat and pale after 12 months.
Clinicians define hypertrophic scars as scars that do not grow beyond the boundaries of the original wound and keloids as scars that spread into the surrounding normal skin.
Hypertrophic scars and keloids may be itchy, tender, or painful. These unusual scars may occur as a result of genetics—they sometimes run in families, and typically, if one forms after an injury, it forms after your subsequent injuries, too. But why they form in some people and not others isn't known.
The scar will appear to become more lumpy and redder at first. This process will take between two and six weeks. Between approximately four and eight weeks the scar will look much wider and redder than it did initially. This is usually the worst the scar will look, and this is a natural part of the healing process.
Hypertrophic scars usually start to develop within weeks after the injury to the skin. Hypertrophic scars may improve naturally, although this process may take up to a year or more. In treating hypertrophic scars, steroids may be the first line of therapy with this type of scar, although there is not one simple cure.
You should carry on massaging your scars for at least three to six months after your surgery or injury.
A surgeon may also remove a large hypertrophic scar rather than revise it. Removing a scar enables a surgeon to reclose the incision using specialized cosmetic techniques, resulting in a thinner, less noticeable scar.
Bio-Oil helps to improve the appearance of new or old scars; whether from surgery, accidents, burns, insect bites, scratches or conditions such as acne or chickenpox. Although younger scars will have a greater chance of improvement, studies have shown that older scars also benefit from regular use of Bio-Oil.
Maturation- Maturation is the stage of healing when a scar softens, flattens and fades. You'll notice your wound looking more like the skin that was once there. During this stage, the body is strengthening the area. Depending on the severity of the wound, maturation may take a year or more to fully complete.
When a scar first develops on lighter skin, it's usually pink or red. Over time, the pinkish color fades, and the scar becomes slightly darker or lighter than the color of the skin. In people with dark skin, scars often appear as dark spots. Sometimes scars itch, and they may be painful or tender.
Scar tissue is usually red at first, then pink for 3-6 months and then fades to a slightly lighter than normal skin color. Exposure to heavy sunlight may cause a scar to heal darker. Sun avoidance and use of sunscreen over scar sites is advisable for six months after surgery.