​Dermatology - Hypertrophic Scars

​Dermatology - Hypertrophic Scars  
Keloids and hypertrophic scars are thick, rigid tissues that grow back after skin is hurt.
Keloids spread beyond the original wound, while hypertrophic scars stay close to it.

The lesions vary from papules to nodules to  tuberous lesions. They are usually the color of skin, but they can be bright red or blue. They are firm to hard and have a smooth surface. After a blow or surgery, they may be straight, oval, or round. Common places for lesions to show up are on the ears, shoulders, upper back, and chest.

A clinical diagnosis is enough to make a decision. A biopsy is not necessary unless there is clinical question, as this could lead to new hypertrophic scarring. Dermatofibroma, dermatofibrosarcoma protuberans, desmoid tumor, scar with sarcoidosis, and foreign-body granuloma are some of the differences.

It's hard to manage because no medicine works very well. Triamcinolone (10–40 mg/mL) injected into the lesion once a month may reduce itching or sensitivity, as well as flatten and decrease the size of the lesion. This works better on hypertrophic scars than on keloids. When carefully removed, lesions often come back bigger than they were before.
Excision followed right away by radiation treatment is helpful. Compression dressings can help keep hypertrophic scars from forming after burns.