and Preventing Hypertrophic Scars: Expert Insights

Prevention of Hypertrophic Scars

Hello Dr.
Wu: I have two small raised scars on the back of my hand from a previous car accident.
They are within the range of the original wounds and have not changed in size.
Could this be a keloid? (I can provide photos.) Recently, I sustained another injury that resulted in a large abrasion.
Would using Mepilex be effective? I plan to apply it immediately after the wound heals.
Additionally, I would like to ask...
since the wound area is large, I want to minimize irritation, so how often should I clean the Mepilex? Also, the surface of my wound has healed, but there is still internal bruising that appears purple.
What could be the cause of this? How long might it take to heal? Thank you!

Niming, 20~29 year old female. Ask Date: 2017/11/15

Dr. Wu Yuxin reply Dermatology

1.
In the initial stage of wound healing, the wound should be treated.
Is Mepilex used for wounds or for scars?
2.
The Mepilex Border Lite should be cleaned and dried each time it is removed.

3.
Without seeing the wound, it is uncertain.

Reply Date: 2017/11/15

More Info

Hypertrophic scars, often referred to as keloids, are raised scars that develop when the body produces too much collagen during the healing process. They typically appear as thick, raised areas of scar tissue that can be itchy or painful. Understanding and preventing hypertrophic scars involves recognizing the factors that contribute to their formation and employing strategies to minimize their occurrence.

Understanding Hypertrophic Scars
1. Causes: Hypertrophic scars can develop after any type of skin injury, including cuts, burns, surgical incisions, and even acne. They are more common in individuals with darker skin tones and can be influenced by genetic predisposition. The overproduction of collagen during the healing process leads to the formation of these raised scars.

2. Characteristics: Unlike keloids, which extend beyond the original injury site, hypertrophic scars remain confined to the area of the wound. They may appear red or purple initially and can gradually fade to a lighter color over time. However, they can remain raised and may not completely flatten.

3. Symptoms: Hypertrophic scars can be itchy, tender, or painful. They may also restrict movement if located near joints.

Prevention Strategies
1. Wound Care: Proper wound care is crucial in preventing hypertrophic scars. Keeping the wound clean and moist can promote optimal healing. After a wound has closed, silicone gel sheets or silicone ointments can be applied to help flatten the scar and reduce its appearance.

2. Avoiding Tension: Tension on the wound site can exacerbate scar formation. It's important to avoid activities that may stretch the skin around the wound during the healing process.

3. Sun Protection: UV exposure can darken scars and make them more noticeable. Using sunscreen on healing wounds can help prevent discoloration.

4. Pressure Therapy: For individuals prone to hypertrophic scars, pressure garments may be recommended. These garments apply consistent pressure to the scar, which can help flatten it over time.

5. Injections: Corticosteroid injections can be used to reduce inflammation and flatten hypertrophic scars. This treatment is often administered by a dermatologist.

Treatment Options
1. Silicone Gel Sheets: As mentioned, silicone gel sheets can be effective in flattening hypertrophic scars. They should be applied once the wound has healed and can be worn for several hours a day.

2. Laser Therapy: Laser treatments can help reduce redness and improve the texture of hypertrophic scars. This option is typically considered for more severe cases.

3. Surgical Revision: In some cases, surgical removal of the hypertrophic scar may be necessary, followed by appropriate wound care to minimize the risk of recurrence.

Addressing Your Concerns
Regarding your specific situation with the scars on your hand from a car accident, it’s essential to evaluate whether they are indeed hypertrophic scars or another type of scar. If they are raised and confined to the injury site, they may be hypertrophic.
For your recent injury and the use of Mepilex (美皮豐), it is generally recommended to keep the dressing clean and change it according to the manufacturer's guidelines or your healthcare provider's advice. If the wound is large, cleaning it every 2-3 days may be sufficient, but always follow the specific instructions provided by your healthcare provider.

The purple coloration you observe in the area of the injury is likely due to bruising, which is common after trauma. This discoloration typically resolves as the body heals, usually within a few weeks, depending on the severity of the injury.

In conclusion, understanding hypertrophic scars and employing preventive measures can significantly impact their formation and appearance. If you have ongoing concerns about your scars or the healing process, consulting with a dermatologist or a healthcare professional specializing in wound care would be beneficial. They can provide personalized advice and treatment options tailored to your specific needs.

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