What should you know about purple hypertrophic scar?

Purple colour can occur while a scar is actively maturing, when altered blood flow and new scar tissue affect the surface. A hypertrophic scar is usually thick and raised but stays within the boundaries of the injury or incision. It may be itchy, tender, firm, or restrictive, particularly near a joint. A keloid can extend beyond the original wound, so the border and growth pattern help a clinician distinguish them. Colour alone cannot establish the diagnosis, and a scar that changes suddenly should be checked.

Avoid scratching and friction, keep healed skin moisturised if advised, and protect it from sun exposure. Do not cut into a scar or use unprescribed strong creams. Depending on thickness, symptoms, location, and skin type, treatment may include [Steroid Injection Into The Skin](/treatments/injectables/intralesional-steroid-injection/) or [Fractional Laser Treatment](/treatments/laser-and-energy/fractional-laser-treatment/). Selected scars may be considered for [Scar Revision Surgery](/treatments/surgical-dermatology/scar-revision-surgery/); [Surgical Excision](/treatments/surgical-dermatology/excisional-surgery/) is not suitable for every raised scar and needs specialist planning.

Arrange assessment if the scar is enlarging, increasingly painful, very itchy, cracking, bleeding, or limiting movement. Seek prompt care for warmth, pus, spreading redness, fever, or a wound that has reopened. A scar that grows beyond the original injury should be reviewed because it may behave differently from a hypertrophic scar.

Does the scar stay within the original wound? Which treatment targets its thickness, itch, colour, or tightness? How might my skin type affect healing and the chance of further scar formation?