What should you know about an old hypertrophic scar?

Hypertrophic scarring is an overgrowth of repair tissue within the outline of an injury, operation or burn. The area can feel thick, tight, itchy or tender, and it may gradually become softer or less noticeable. Unlike a keloid, it does not extend beyond the original wound edge, although only an examination can distinguish scar types reliably.

A clinician will consider how long the scar has been present, whether it is still changing, its location, colour and thickness, and whether movement is restricted. A photograph or old wound history can help explain its evolution.

Protect the scar from repeated friction and use sunscreen on exposed skin. Do not scratch, cut or repeatedly irritate the area. If it is itchy or tight, arrange a dermatology assessment before trying strong creams or home devices.

Treatment depends on the scar’s thickness and symptoms. Options may include steroid injection into the scar, fractional laser treatment for texture or colour, or surgery in selected cases. Surgery can create another scar and requires a plan to reduce regrowth. Recovery, skin tone and the scar’s position all influence the choice.

Seek prompt medical review if the scar develops a new ulcer, bleeding, rapid enlargement, marked pain, warmth, drainage or a persistent change in colour. Arrange routine review if itching, tightness or restricted movement continues, or if the diagnosis is uncertain.

Ask whether the scar is hypertrophic or keloid, whether treatment is intended to reduce symptoms or appearance, how many visits may be needed, and how recurrence or pigment change will be managed.