Types of Scars

Atrophic scars

In comparison to surrounding skin atrophic scars are flat and depressed. Generally they are small and often round with an inverted or indented center. They are commonly associated with acne or chickenpox.

Hypertrophic scars

Hypertrophic scars are raised scars which remain within the boundaries of the original lesion. They can regress spontaneously after the initial injury. These scars are often inflamed and red, itchy, and even possibly painful. Typically hypertrophic scars occur following burn injury on the trunk and extremities.

Intermediate scars

These are scars that are difficult to categorize. Nevertheless, if a raised scar is still emerging after a year, a true keloid is a potential diagnosis. Hypertrophic scars should show some evidence of regression within this time.

Keloid scars

These are raised scars that spread beyond the margins of the original wound and invade the surrounding skin. Ear lobe keloid scars can often grow as large lobules and central sternal keloids can commonly develop a butterfly-like shape. Deltoid keloids tend to extend vertically.
Over time, a keloid continues to grow and does not regress spontaneously. It invariably recurs after excision (50-80%). Keloids may be inflamed and itchy and even painful, especially during the growth phase. Keloid scarring is unique to humans and there seems to be predispositions with dark skinned races being more prone to this type of scarring. They develop predominantly in people aged 10-30 years, with an apparent predilection for emergence and deterioration during puberty and pregnancy.

Scar contractures

Scars across joints or skin creases at right angles are prone to develop shortening or contracture. These often tend to be hypertrophic and occur when the skin is not fully matured. Typically scar contractures are disabling and dysfunctional. These scars are common following burn injury across joints or skin concavities.

Surgery and stretch-mark scars

Usually during the three weeks following surgery these appear when the fine lines of surgical scars gradually become stretched and widened. Typically they are flat, pale, soft, symptomless and are relatively often seen after knee or shoulder surgery.A Common example of this scar are stretch marks after pregnancy. In stretch marks there has been injury to the dermis and subcutaneous tissues, however the epidermis is unbreached. Since there is no elevation or thickening in mature widespread scars, they can be well distinguished from hypertrophic scars.

Keywords: types of scars, scarring, atrophic, hypertrophic, keloid scars, scar contractures, stretch-mark, surgery scars, scars