There are three different types of scars: atrophic, hypertrophic, and keloidal. Each type has its own characteristic.
Let’s see the overview.
ATROPHIC SCARS
Atrophic scars are dermal depressions most commonly caused by collagen destruction during the course of an inflammatory skin disease, such as cystic acne or varicella, and cause a valley or hole in the skin.
It is listed as a type of or related-symptom for symptom skin atrophy. Scarring after inflammatory or cystic acne can manifest as atrophic, saucerized, ice pick, or boxcar scars. Atrophic scars usually respond well to laser therapy.
HYPERTROPHIC SCARS
Hypertrophic scars are raised, firm, erythematous scars formed as the result of overzealous collagen synthesis coupled with limited collagen lysis during the remodeling phase of wound healing. It usually caused by burns, tension on the skin or skin reaction at the time of injury.
When hypertrophic scars reach a certain size, it subsequently stabilizes or regresses. Hypertrophic scars are more common on the back and shoulders than on the face.
Despite the obvious tissue proliferation, hypertrophic scars remain within the confines of the original integument injury and may regress with time. Although children are more prone to hypertrophic scars, no racial or familial preponderance occurs with hypertrophic scarring.
Hypertrophic scars also do not invade normal tissue, and lies across the relaxed skin tension lines (creases in the skin). If located in an amenable anatomic location, hypertrophic scars can generally be treated with simple excision, providing wound closure can occur without undue tension.
KELOIDS
Keloids are actually non-malignant tumors formed by scar tissue that exceeds the boundaries of an original incision or injury. These raised, reddish-purple, nodular scars, upon palpation, are firmer than hypertrophic scars.
Keloids exhibit a prolonged, proliferative phase resulting in the appearance of thick hyalinized collagen bundles similar to those produced by hypertrophic scars, but extend beyond the margins of the inciting wound and do not regress over time.
Although they can be seen in all skin types, keloids appear most frequently in patients with darker skin tones, 10-30 year olds and people with burn injuries. Mostly these patients are related to an inherited metabolic alteration in collagen.
Keloids are seen with greater frequency in blacks, Hispanics, and Asians. The high recurrence rate of keloids has initiated a wide variety of different treatment approaches.
All types of scarring can occur on all areas of the body, but some areas such as the chest, knees and elbows are more likely to scar.
