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How To Rule Out Hypertrophic Scar?

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Posted on Wed, 2 Dec 2015
Question: Dr Chandrakant,

I'm sorry it's taken this long to answer the questions you sent me; I've been out of town. I tried to reply but our connection closed automatically. I'll respond here and will hope you can connect me to our earlier conversation.

Your questions:
- Does it feel hard if you palpate the scar with finger? Yes, there is a hard thickening below the incision toward my toes.
- Can you differentiate the swelling as hard from the surrounding if you try to hold with two fingers from sides like pinching? Yes, especially when I compare by pinching the same area on my other foot.

- Is there a line of differentiation between the scar tissue or a lump and the surrounding? Not visually but to the sides of the incision it feels the same as my other foot, thicker/harder directly beneath the incision.

- Can you please post clear photographs in different angles for me to see to have visual impression? Yes, if I can figure out how to do it! I'll include photos of Day 3, Week 6, and now.

I'm not able to attach the photos. Perhaps you have to reply first? If so, just say hi, no need to repeat your original words.

Thank you so very much for sharing your knowledge and wisdom.

Best,
XXXXXXX Mintz

doctor
Answered by Dr. T Chandrakant (1 hour later)
Brief Answer:
Most probably - Hypertrophied scar. This is treatable and curable.

Detailed Answer:
Sincere thanks for your feedback and clear serial photographs.
They are so clear and self-explanatory and gives on-the-spot diagnosis as we say in our medical jargon.

This is called hypertrophic scar.
The treatment is medical or surgical.

The medical treatment is pressure bandage applied over the scar to reduce its size and redness and to flatten it out. Due to the odd position of the scar is bit difficult to apply such pressure bandage in such a area; but I think it is worth trying.
Second line of treatment is Local injection of Triamcinolone into the scar tissue and this works the best, gives the best results.
And if these therapies fail then only a surgical correction option is needed, and you may not need any surgery.

There is a tendency in some people to form such scars irrespective of hte place of injury/surgery.
I would like you to remember if you had any injury in the past and remember the response of your body at that time.

In most of the patients the scar stabilizes or reduces/ flattens over 6 - 12 month period
The Anti-oxidants in the form of multivitamins do help in good recovery. Please start taking.

You may please discuss these points with your Operating Surgeon/ Dermatologist and carry on the treatment and the scar will be fine, there will be no symptoms.

I hope this answer helps you to get a complete cure.
Wishing you all the best.
Please feel free to ask for further queries if you need to or if you feel that there is a gap of communication.

Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
Dr.
Dr. T Chandrakant

General Surgeon

Practicing since :1984

Answered : 19778 Questions

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How To Rule Out Hypertrophic Scar?

Brief Answer: Most probably - Hypertrophied scar. This is treatable and curable. Detailed Answer: Sincere thanks for your feedback and clear serial photographs. They are so clear and self-explanatory and gives on-the-spot diagnosis as we say in our medical jargon. This is called hypertrophic scar. The treatment is medical or surgical. The medical treatment is pressure bandage applied over the scar to reduce its size and redness and to flatten it out. Due to the odd position of the scar is bit difficult to apply such pressure bandage in such a area; but I think it is worth trying. Second line of treatment is Local injection of Triamcinolone into the scar tissue and this works the best, gives the best results. And if these therapies fail then only a surgical correction option is needed, and you may not need any surgery. There is a tendency in some people to form such scars irrespective of hte place of injury/surgery. I would like you to remember if you had any injury in the past and remember the response of your body at that time. In most of the patients the scar stabilizes or reduces/ flattens over 6 - 12 month period The Anti-oxidants in the form of multivitamins do help in good recovery. Please start taking. You may please discuss these points with your Operating Surgeon/ Dermatologist and carry on the treatment and the scar will be fine, there will be no symptoms. I hope this answer helps you to get a complete cure. Wishing you all the best. Please feel free to ask for further queries if you need to or if you feel that there is a gap of communication.