Hypertrophic Scars are typically raised, red or pink and sometimes itchy but do not exceed the margins of the original wound. They usually subside with time. Histologically, hypertrophic scars have flatter type III collagen bundles, with fibers arranged in a wavy pattern, but predominately oriented parallel to the epithelial surface. Collagen synthesis is six times as great as in normal unscarred skin and the ratio of type I to type II collagen is also higher. Hypertrophic scars also have nodular structures of alpha-smooth muscle actin, which expresses myofibroblasts, small vessels and fine collagen fibers. There is also an overproduction of TGF-B and PDGF.

Keloids on the other hand range in consistency from soft and doughy to hard and rubbery. They do not infiltrate into the surrounding normal tissue and continue to evolve over time with no regress phase. Histologically, collagen bundles are not present but instead the collagen type I and type III fibers lie in a haphazardly connected loose sheet randomly orientated to the epithelial surface. In addition, the collagen synthesis is approximately 20 times greater as that in normal unscarred skin and the ratio of type I to type II collagen is also higher. Keloids also have an overproduction of the growth factors TGF-B and PDGF produced by fibroblast proteins. In comparison to the above two abnormal histological feature, normal skin contains collagen bundles running parallel to the epithelial surface.

Clinical Features of Hypertrophic Scars and Keloids

Hypertrophic Scars



Develop soon after surgery May develop months after the trauma
Usually improve with time Rarely improve with time
Remain within the confines of the wound Spread outside the boundaries of the initial lesion
Occur when scars cross joints or skin creases at a right angle Occur predominantly on the ear lobe, shoulders, sternal notch, rarely develop across joints
Improve with appropriate surgery Are often worsened by surgery
Have no association with skin color Are associated with dark skin color

Silicone is the only noninvasive option for which evidence-based recommendations have been made for both scar treatment and prevention by leading specialists worldwide. In the largest clinical study of silicone gels the effectiveness of the treatment was rated as “good” or “very good” by 82.6 % of all physicians and by 81.4 % of all patients. (See Strataderm case studies)

Strataderm is used for the prevention and treatment of keloids and hypertrophic scars – old and new.

Strataderm was developed for use on all types of scars including those resulting from:

 • General surgery

• Trauma

• Chronic wounds

• Burns

• Bites

• Acne and other diseases of the skin

Strataderm can also be used in conjunction with other invasive scar management options to improve overall results, including surgical excision and resuturing, intralesional injections and pressure garments.

You can learn more about Strataderm on www.strataderm.com, follow us on Facebook or Twitter.