Hypertrophic scar
Template:Infobox medical condition (new) A hypertrophic scar is a cutaneous condition characterized by deposits of excessive amounts of collagen that create a raised scar, but not to the degree observed with keloids.<ref name="Bolognia">Template:Cite book</ref> Like keloids, they form most often at the sites of pimples, body piercings, cuts and burns. They often contain nerves and blood vessels. Hypertrophic scars generally develop after thermal or traumatic injury that involves the deep layers of the dermis and express high levels of TGF-β.<ref>Template:Cite journal</ref>
CauseEdit
Mechanical tension on a wound has been identified as a leading cause of hypertrophic scar formation.Template:Refn
When a normal wound heals, the body produces new collagen fibers at a rate that balances the breakdown of old collagen. Hypertrophic scars are thick, red to brown in coloration, and may be itchy or painful. They do not extend beyond the boundary of the original wound but may continue to rise or thicken for up to six months. Hypertrophic scars usually heal and fade over one to two years. Hypertrophic scars may cause distress due to their appearance or the intensity of itchiness. They can also restrict movement if located close to a joint.<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref>{{ safesubst:#invoke:Unsubst||date=__DATE__ |$B= Template:Fix }}
Some people may have an inherited tendency to develop hypertrophic scarring, for example, those with Ehlers–Danlos syndrome.Template:Cn
PreventionEdit
It is not possible to completely prevent hypertrophic scars, so those with a history of them should inform their doctor or surgeon if they need surgery. Pressure garment therapy is a commonly used approach to try to prevent hypertrophic scarring after a burn, but the effectiveness of this approach is unclear.<ref>Template:Cite journal</ref>
ManagementEdit
Early hypertrophic scars should be treated by applying pressure or massage during the first 1.5–3 months.<ref name=":2">Template:Cite journal</ref> If necessary, silicone therapy should be applied later. Ongoing hypertrophy may be treated with corticosteroid injections.<ref name=":2" /> Surgical revision may be considered after 1 year.<ref>Template:Cite journal</ref>
Silicone gel sheetingEdit
Silicone gel sheeting is sometimes used to treat hypertrophic scars. Silicone gel sheets may improve the appearance of scars slightly compared with applying onion extract and may reduce pain compared with no treatment with silicone gel sheets or pressure garments.<ref name=":0">Template:Cite journal</ref> It is uncertain whether silicone gel sheets are more effective than other treatment methods.<ref name=":0" />
Laser therapyEdit
Laser therapy is an approach that has been studied for treating hypertrophic scars.<ref name=":1" /> There is not enough evidence to determine if laser therapy is more effective than other treatments, or if laser therapy leads to more harm than benefit as compared to no treatment or different treatment.<ref name=":1">Template:Cite journal</ref>
CryosurgeryEdit
Cryosurgery, using extreme cold to remove dead tissue, may speed up the healing process of a hypertrophic scar to a flatter, paler appearance.<ref>Template:Cite journal</ref>Template:Update needed