The treatment options available will be dependent on the type and degree of scarring present.
Hypertrophic
This type of scar is seen when there is an over production of collagen causing the scar to be raised above the surrounding skin. They can appear to be a raised red “lump” on the skin. They will typically present at approximately 4 to 8 weeks after the initial insult. They are generally seen after a wound infection or a closure with excessive tension, but can also be seen with other traumatic skin injuries. These scars tend to grow within the confines of the initial wound. Hypertrophic scars may improve on their own, but may take a year or more to do so.
Keloid
This scar can occur on anyone, but most common in dark-skinned individuals suck as blacks and people of Mediterranean descent. They can occur secondary to surgery, accidents, acne, and even body piercings. While they can occur anywhere on the body it will generally be seen on the shoulders and chest areas. While they are harmless they can be painful and itchy. They differ from hypertrophic scars in that they do not stay within the initial boundaries of the wound and can grow indefinitely. Keloids may also appear up to one year after the original wounding of the skin.
Atrophic
This form of scar is characterized as a sunken recess in the skin. This appearance is due to the loss of skin support. It is most commonly seen with acne, chickenpox, infections, accidents, but can also develop after a surgical procedure.
Stretch Marks
Also known as striae, they tend to occur when the skin is stretched rapidly such as during pregnancy, massive weight gain, and even adolescent growth spurts. During this period the dermis, the “true” skin, is torn. Therefore the supporting structure of the epidermis is lost allowing for the underlying layers to “show through”. This type of scar is thought to be related to elevated corticosteroids. They tend to occur most often in the abdomen, buttocks, breast, and thigh regions and are usually thin and long.
Scar Contracture
This type of scar is most often seen after a burn, especially over a large area of skin. The scar that forms will begin to tighten the skin in essence reducing the total surface area of the injured skin. This decrease in relative size can have an impact on your muscles and joints leading to a decrease in motion across a joint(s) reducing your functional capabilities as well as causing a cosmetic deformity.
