How effective is steroid injection for a hypertrophic scar?

A hypertrophic scar stays within the original wound area but becomes thick, firm, raised, itchy, tender, or tight. An intralesional steroid places medicine inside the scar rather than spreading it over the surrounding skin. The medicine can reduce local inflammation and slow the activity of cells that maintain excess scar tissue. As the scar softens, its height, firmness, colour, and discomfort may become less noticeable. Older, very dense scars can respond differently from newer or actively changing scars.

A dermatologist first checks that the raised area is a hypertrophic scar and not a keloid, infection, or another growth. Treatment is commonly planned as a series of appointments, with time between them to assess softening and skin response. The injection can sting, and the scar may be sore briefly afterward. Tell the clinician about previous scar treatments, skin infections, diabetes, medicines, and any tendency to develop thin or lighter skin. Do not pick the area while it settles, and follow the wound-care instructions provided.

Contact the treating clinic if pain, warmth, swelling, drainage, or redness is increasing rather than settling, or if the scar breaks down. Seek prompt assessment for fever, rapidly spreading redness, or severe pain. Arrange review if the scar keeps enlarging beyond the original wound, because that pattern can suggest a different type of raised scar and may change the treatment plan.

Ask whether the scar is hypertrophic or keloid, what change is realistic for its age and thickness, how progress will be judged, and which alternatives could be considered if injections do not provide enough softening. Ask about skin thinning, colour change, discomfort, aftercare, and when the next review should occur.