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do-hypertrophic-scars-go-away

Gracie 26-07-10 03:18 3 0

Do Hypertrophic Scars Go Away?

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The honest answer is yes — most hypertrophic scars do improve substantially over time, and many continue to flatten and fade for 12 to 24 months after the original injury. But "go away" is a strong phrase. A hypertrophic scar that has reached maximum maturity typically becomes much less raised, less red, Birthmarks and blemishes (check out this one from Peptidesupermarket) less obvious than it was at 6 to 8 weeks post-injury. It does not completely disappear. What it becomes is a fine, pale, mature scar that is far easier to live with than the active raised scar.

Whether you should simply wait for natural or actively treat the scar depends on several factors: how the scar is behaving at each stage, your skin type, the anatomical location, and how much the scar is bothering you. Early intervention often prevents a hypertrophic scar from establishing in the first place — which is meaningfully different from trying to revise a mature one.

For background on the full range of scar types and how each forms, start with . For the wider service, see at Centre for Surgery’s CQC-regulated Baker Street private hospital.

What is a hypertrophic scar?

A hypertrophic scar is a raised, firm, often red or pink scar that stays within the boundaries of the original wound. It forms when the body produces more collagen than was needed for repair. The excess collagen sits in disorganised that thicken the scar and lift it above the surrounding skin.

The key distinguishing feature: a hypertrophic scar stays within the lines of the original injury. It can be raised, firm, itchy or tender — but it does not grow into previously skin. This is the most important difference from a keloid, which extends beyond the original wound boundary into healthy tissue and rarely improves spontaneously.

Hypertrophic scars are most common:

If you’re unsure whether your scar is hypertrophic or keloid, the rule of thumb is geographic: does the scar end at the line of the original injury (hypertrophic), or has it grown beyond it (keloid)? This distinction matters because the approach and the expected natural history differ.

Why hypertrophic scars often improve on their own

Hypertrophic scars peak in intensity at around 6 to 12 weeks after the injury — this is the point at which the body’s collagen production is highest. After that point, the body’s remodelling machinery begins to break down some of the excess collagen and reorganise the rest into a more normal pattern. Over 12 to 24 months, most hypertrophic scars:

The natural history is the reason surgical revision is usually deferred for at least 12 months — many scars that look concerning at 6 weeks will look much better at 12 months without any intervention at all.

That said, "wait and see" isn’t always the right answer. Active treatment during the maturation window can substantially accelerate improvement and may prevent the scar from becoming established in the first place. The best results typically come from patience with appropriate early intervention.

The standard treatment approach

Treatment of a hypertrophic scar is layered. The first-line interventions are non-surgical and started early; surgical revision is reserved for the minority of scars that don’t respond.

The single intervention with the strongest evidence base. Silicone applied to a fully closed wound:

Practical use: start once the wound has closed (around 2 weeks). Gel applied twice daily, or sheeting worn for 12+ hours a day. Continue for at least 3 months — ideally 6. For dedicated discussion see

Triamcinolone steroid injected directly into the scar tissue is the workhorse for established hypertrophic scars. The mechanism is suppression of fibroblast and reduction of collagen overproduction. Given as a course every 4–6 weeks for 3–6 sessions, intralesional steroid produces measurable flattening and softening in the majority of cases.

Steroid injection works best when started early — once a scar is showing concerning raised, firm, red features at 6–8 weeks post-operation. Catching the scar at this stage often prevents it from establishing fully. Intervention on a mature 12+ month hypertrophic scar still helps but more sessions and produces less dramatic results.

Several laser modalities help hypertrophic scars:

combines microneedling with deep radiofrequency energy to remodel scar tissue at depth. For hypertrophic scars it produces collagen reorganisation and progressive flattening over a course of 3–4 sessions. Particularly useful where the scar is over a larger area, or for patients with skin types where ablative laser carries more pigmentation risk.

Sustained mechanical pressure (typically 24+ kPa) applied to a scar reduces collagen production and can flatten an established hypertrophic scar. Used as:

Pressure therapy is less used after standard surgery because compression garments don’t fit usefully over typical incision sites — but for the right anatomical location it remains an evidence-based option.

The best results often come from combining modalities. A common protocol for a developing hypertrophic scar at 8 weeks post-operation:

For most scars, this combined approach produces improvement within 4 to 6 months and avoids the need for surgical revision.

When is surgical revision considered?

Surgical excision of a hypertrophic scar is rarely the first-line approach. The reason: out the scar and re-closing the area in the same place often produces another hypertrophic scar — because the underlying factors that caused the first one (anatomical tension, skin type, individual healing pattern) are still present.

Surgical revision is when:

Where surgical revision is appropriate, it is almost always combined with post-operative intralesional steroid injection and intensive silicone treatment to prevent the new scar from going hypertrophic again. See for full discussion.

Hypertrophic scars by anatomical location

The risk of developing a hypertrophic scar — and the natural history once one has formed — varies considerably by where on the body the wound is.

Knowing the risk profile of the anatomical site informs how aggressively the scar should be managed from the start.

How long until a hypertrophic scar matures?

A typical maturation timeline for a hypertrophic scar:

This is the timeline without intervention. With early silicone use, appropriate steroid injection, and adjunctive laser or Morpheus8, the is shifted favourably — the scar less raised earlier and reaches a better final endpoint.

Hypertrophic vs keloid: the practical difference

The two are often confused. Both are raised, firm, sometimes red and itchy. The practical distinctions:

If your scar is into previously healthy skin, that’s a keloid pattern and warrants different management. See for piercing-related keloids, and discuss directly with a plastic surgeon for any keloid affecting a sensitive area such as the chest or earlobe.

What we don’t recommend

Frequently asked questions

"Go away" overstates what happens. Most hypertrophic scars improve substantially over 12 to 24 months — becoming less raised, less red, less obvious. They do not completely disappear. With appropriate treatment, the endpoint is a fine pale mature scar that is much easier to live with.

Hypertrophic scars treated non-surgically (silicone, steroid, laser) rarely come back in the same way once flattened — the underlying collagen has been reorganised. Surgical revision without combined post-operative has a higher recurrence rate, which is why combined approaches are standard.

Intralesional steroid injection the most rapid and reliable flattening. A course of 3–4 injections every 4–6 weeks typically shows clear improvement within 2 to 3 months. Combined with silicone and sun protection, the results are better still.

No scar can be removed completely — the underlying skin structure has been permanently altered. What treatment can achieve is making the scar significantly less raised, less red, and less obvious. For many patients, the end result is a fine pale line that’s hard to see without close inspection.

Yes — Morpheus8 produces collagen that gradually flattens and scarring over a course of 3–4 sessions. Particularly useful for larger areas, scars on darker skin types, and as an adjunct to injection.

They are not dangerous in the medical sense — there is no risk of malignant change or systemic harm. They can cause itch, tenderness, restricted movement (when over joints), and significant cosmetic distress. These are legitimate reasons to seek treatment.

Not necessarily. Even patients with a history of one hypertrophic scar can have other procedures heal cleanly with appropriate — incisions in lower-tension anatomical sites, careful technique, and intensive post-operative scar . The risk is real but it isn’t an automatic outcome.

Yes — typically very well. Pressure earrings, intralesional steroid injection, and (occasionally) surgical removal with post-operative steroid are the mainstays. Earlobe piercing scars respond particularly well to early treatment.

Intralesional steroid injection sessions typically £150–250 each. Laser sessions £350–600. Morpheus8 from £900. Surgical revision £1,500–4,000+. available. For full cost discussion see

The earlier the better. A scar showing raised, firm, red features at 6–8 weeks is the ideal time for first assessment — early intervention prevents the scar from becoming fully established. Don’t wait for the scar to "settle" if it’s going in the wrong direction.

Centre for Surgery is a CQC-regulated plastic surgery clinic at 95–97 Baker Street, Marylebone. We offer the full range of treatments for hypertrophic scars — silicone management, intralesional steroid injection, pulsed-dye and fractional laser treatment, , and where appropriate . All performed by GMC-registered consultant plastic surgeons. No GP referral required.