How to eliminate hypertrophic scars?

Written by Tang Da Wei
General Surgery
Updated on September 28, 2024
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For the elimination of hypertrophic scars, one can apply anti-scarring ointment to the surface early after surgery. If the patient indeed has a scarring constitution, at the end of the surgery, it is advisable to inject medications into the subcutaneous area or within the wound tissue to prevent excessive or abnormal scar proliferation. If necessary, radiotherapy can be applied; under the effect of X-rays, it can effectively prevent the abnormal proliferation of scar tissue and the abnormal and excessive growth of fibroblasts. If there is already hypertrophic scarring, one might consider excising the hypertrophied scar tissue and re-suturing the wound.

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Can keloids be cured?

Once keloids appear, they are essentially irreversible, meaning that they cannot be completely cured clinically. The formation of keloids is mostly related to one's own constitution, such as a keloid-prone skin type. Some keloids are also due to trauma occurring in areas of the skin where muscular tension is relatively high, or where the wound is indeed large and deep, which might lead to the formation of keloids. In such cases, localized drug injections can be used to reduce and soften the keloids. One can also use ointments that soften scars, such as keloid soothing and softening cream, but these require long-term application to be effective. If the keloid is relatively small, cosmetic surgery to remove and re-sew the area can also be an option for treatment. In summary, once keloids have developed, they are not easy to completely cure.

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What should I do about auricular keloids?

Auricular keloids are a relatively common clinical condition, which may be related to an individual's scar constitution. Firstly, it is necessary to examine the size of the keloid. If the keloid is small, without obvious enlarging, redness, pain, infection, or inflammation, this situation generally can be considered for observation followed by regular ENT (ear, nose, and throat) specialist follow-ups to check for any rapid growth. However, if the keloid is large and progressively growing, surgical removal should be considered. After the surgery, local superficial radiation therapy can be considered to help prevent postoperative recurrence.

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What does "scar constitution" mean?

Scar constitution is a type of special genetic constitution, typically leading to larger scars from minor injuries, especially in areas such as the chest and back where skin and muscles are tense. People with scar constitution should avoid injuries or bumps, particularly avoiding scratching or squeezing folliculitis on the chest, as scars formed are difficult to completely remove. Common anti-scar medications often do not work well. If scar proliferation is significant, treatment with medical injections in a standardized hospital's dermatology department may be required. Regular exercise, boosting the immune system, avoiding spicy or irritating food, and avoiding staying up late can help reduce the frequency of this condition.

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The difference between hypertrophic scars and keloids

In a strict sense, hypertrophic scars and keloids are similar in their pathogenesis. For hypertrophic scars, the typical presentation is localized overgrowth at the scar site, which means that there is an overgrowth during the wound healing process, resulting in a relatively large and numerous scar. Keloids represent a more severe condition where there is a localized raised scar on the wound, which can be significantly large, sometimes resembling a bug on the surface of the scar. They are more likely to occur in areas like the neck, behind the ears, and under the earlobes. For the treatment of hypertrophic scars and keloids, if the patient has a predisposition to scarring, considerations include early intervention during wound suturing and healing, such as injection of medications or radiation therapy.

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What should I do if a keloid is itchy?

Keloids can be very itchy when at home. You can use some cryotherapy such as applying ice for treatment. However, if the results are unsatisfactory, it might be necessary to visit a hospital for a comprehensive treatment, including medication. Treatment based on the condition can control these symptoms. The itching occurs because the skin's metabolic system is damaged, causing metabolic products to accumulate in the scar.