Major burn injuries are likely to result in hypertrophic scars that rise above the surface of the skin. According to the Model Systems Knowledge Translation Center, hypertrophic scars form when the collagen fibers that the body produces to heal the damage become disorganized, changing the appearance and texture of the healing skin.
Hypertrophic scars can cause complications such as contracture, which is tightness in the skin that can restrict joint movement. There may be several treatments available to treat or prevent hypertrophic burn scars.
Compression garments such as stockings or sleeves may help prevent the formation of hypertrophic scars. It is not entirely clear why, but theoretically, compression may help to control the formation and organization of collagen fibers. Some patients prefer the appearance of compression garments to the healing scars.
This type of therapy is only appropriate after the skin has healed sufficiently to withstand the pressure. If the patient would benefit from additional pressure, he or she can add custom-made inserts under the compression garments.
Stretching and massage
Massaging and stretching the area of the scar may help to prevent contracture by making it softer and looser. Physical therapists can perform massages and stretches specifically for treating hypertrophic scars.
If conservative treatments fail, it may be possible to treat the scar and the resulting contracture with surgical options. For example, laser surgery may be effective at breaking up scar tissue to reduce its appearance.
There are also treatments available to treat other complications of hypertrophic scars. Examples include moisturizers or silicone gel sheets that help protect healing skin from itching and dryness.