From the Research
Scars can be categorized into several types, including hypertrophic, keloid, atrophic, contracture, and stretch marks, each resulting from different healing processes and collagen production patterns. The main categories of scars are:
- Hypertrophic scars, which are raised, red, and confined to the original wound area
- Keloid scars, which are similar to hypertrophic scars but extend beyond the original wound boundaries and may continue to grow over time
- Atrophic scars, which appear as sunken or depressed areas due to tissue loss, commonly seen with acne or chickenpox
- Contracture scars, which develop when skin is burned and can restrict movement by tightening the skin
- Stretch marks (striae), which form when skin rapidly stretches during pregnancy, weight gain, or growth spurts Other types include normotrophic scars, which are flat and match skin color after healing; widespread scars that cover large areas; and scar contractures that pull skin in different directions. According to the most recent study 1, understanding these categories helps healthcare providers determine appropriate treatment approaches, which may include silicone sheets, steroid injections, laser therapy, or surgical revision depending on the scar type. The body's inflammatory response, genetics, wound location, and wound care all influence which type of scar will form, as noted in 2 and 3.
The treatment of keloid and hypertrophic scars remains a challenging clinical problem despite numerous proposed therapies reported in the literature, as discussed in 4. However, surgical excision followed by postoperative intralesional steroid injection seems to provide a reasonable treatment outcome with low recurrence rate, as suggested in 4.
In terms of pathophysiology, keloid and hypertrophic scars represent an aberrant response to the wound healing process, characterized by dysregulated growth with excessive collagen formation, as described in 1. Various cytokines and growth factors have been implicated in the development of these scars, including interleukin (IL)-6, IL-8, and IL-10, as well as transforming growth factor-beta and platelet-derived growth factor, as noted in 1.
Overall, the categorization and understanding of scar types are crucial for determining the most effective treatment approach, and healthcare providers should consider the latest evidence and research when developing treatment plans for patients with scars.