Hypertrophic scars (Cicatrix Hypertrophica) are discolored, mostly red – sometimes pink, purple or other colors, widened, and elevated. They are the result of an excessive healing process after the skin has been damaged. They can be painful, may itch and can be very sensitive. Touching them, sliding clothes or the pressure of for example a seatbelt may produce discomfort.

The disorganized collagen structure of the tissue leads to the thick and elevated appearance. An increased amount of blood vessels results in the red color of the scar tissue. Common causes of hypertrophic scarring are burn injury, wound infection, and tension on the wound and or scar tissue. After a while the scar growth stabilizes and in some cases regresses.

Common hypertrophic scar treatment includes collagen reducing corticosteroid injections, laser therapy, cryosurgery, surgical revision and topical over the counter treatments. Downside of steroid injections is that they flatten the scar but do not treat the discolorization. It is recommended to indulge in these topical DIY measures first because they are easy accessible, low cost and more important; non invasive. The aforementioned more invasive treatments have risks of worsening scar appearance involved.

Most effective topical hyperthropic scar treatments are silicone sheets. Originally used by medical professionals these sheets are now widely used to minimize the size, thickness, stiffness, redness, and itch. Not only do they make the scar softer, flatter and more supple they also prevent new hypertrophic scars from forming.

Silicone ointments such as creams and gels as well as polyurethane dressings have shown to be less effective. The latter are less easy to use and it remains unclear how this therapy works on fresh hypertrophic scars. Vitamin E has shown no efficacy and is associated with skin reactions. On Aloe Vera no research has been done. Onion extract based creams (e.g. Mederma) haven’t shown a demonstrable effect either.

Since hydration seems to be beneficial petrolatum based ointments could be a useful addition. Studies show no benefits of dedicated scar creams compared to e.g. Vaseline.

Learn more about hypertrophic scars by reading my experiences with researching and treating them.