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What Is the Difference Between Atrophic and Hypertrophic Scars?

What Is the Difference Between Atrophic and Hypertrophic Scars?

No two scars are alike. Each one is shaped by genetics, metabolism, perfusion cycles, oxygenation rates, and more – and different wounds respond to different treatments. It’s important, therefore, to understand how the most common tissue tears can be healed. Let’s examine atrophic and hypertrophic scarring.

Read More: Types of Scars

What are Atrophic Scars?

Atrophic scars are flat lesions that appear on the face and body. They’re formed when fatty deposits beneath scar sites disintegrate, causing a sudden recession of collagen and muscle. This decreases the overall elasticity of the skin and creates a shallow, pitted effect.

Atrophic scars are typically associated with skin disorders, such as: chickenpox, cystic acne, or extensive ultraviolet damage. Their sizes, textures, and depths vary greatly. They’re not generally considered painful, but they are often prone to irritation or inflammation.

What are Hypertrophic Scars?

Hypertrophic scars are, unlike their atrophic counterparts, raised lesions. They occur when an excess of collagen builds within the body, causing the tissue to thicken dramatically. They’re clustered around the scar site (unlike keloids, which spiral outward) and feature red, textured appearances.

Hypertrophic scars have many causes – cuts, surgery, burns, or even acne. They will often heal on their own, but the process is slow and sometimes painful (extreme irritation or itching may occur).

How Do Patients Treat These Scars?

Treatment starts with identification. Once patients establish whether they’re suffering from atrophic or hypertrophic scars, they can then quicken the healing process.

Atrophic Scars

Atrophic scars occur when external factors interrupt the body’s collagen process. There are, however, several treatments available to reinvigorate this process:


Cylindrical pads move across the scar site, buffing away olds cells and encouraging the growth of new ones. Skin is gently stimulated and collagen production resumes.

Soft Tissue Injections

Soft tissue injections introduce patients to new collagen, pumping controlled doses directly into the scar site. This slowly rebuilds elasticity and fullness.

Silicone Gels

Silicone gels restore natural hydration levels, helping skin achieve greater mobility. They also soften pitted tissue and minimize the appearance of atrophics.

Hypertrophic Scars

Hypertrophic scars occur when the body releases too much collagen, but several treatments are now available to maintain proper production, including:

Laser Therapy

Laser therapy utilizes bursts of light to penetrate the skin, with high-frequency pulses reversing the collagen flow.

Compression Therapy

Compression therapy relies on varying degrees of pressure (often achieved through bandages) to slowly eliminate build-ups of collagen.

Vitamin C Complexes

Vitamin C complexes infuse tissue with key nutrients, helping to stabilize collagen production. They also reduce redness, irritation, and rigidity.

Before starting any scar treatment program patients should consult with their physicians.

Read More: Get Rid of Scars

Atrophic and hypertrophic scars rank among the most common afflictions worldwide. They affect men, women, and children alike. Learn how to identify them to ensure successful healing.

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Old Scars: Treatment Options

Old Scars: Treatment Options

There are many types of scars, just as there are many types of scar treatments. Individuals are forever bombarded with endless creams, ointments, and abrasion pads – and it can prove confusing to choose between them. For many, the best option is to utilize a variety of natural and medical options when trying to improve the appearance of scars.

Read More: New Or Old Scars

Topical Remedies:

Aloe Vera

This gelatinous extract (from the leaves of the Aloe Vera plant) delivers superior relief during the initial stages of scar healing. It contains anti-inflammatory properties that heal wounded skin, soothing irritation and helping to increase moisture. This softens the scar, keeps is moisturized and improves its appearance, however it does not fade the scar.

Vitamin C

Vitamin C is one of the best ways to fade scars. Always choose a stable form of Vitamin C (such as in InviCible Scars.) Healthy collagen production is necessary to reduce the size and appearance of scarring overall, and that is something that Vitamin C can play a big role in, as this vitamin is essential in the collagen production that is required to formulate healthy connective tissue in a wound.

Dimethicone Silicone

Silicone is one of the best ways to treat old scars. It relieves scar redness, pain and itching, improves scar elasticity and can treat and prevent difficult scars like hypertrophic scars.


Scars often create a lack of moisture in the skin. Honey helps to provide that moisture, providing the tissues with alkaline-rich properties and antioxidants. This revitalizes the hydration process and reduces scarring. Raw honey (not pasteurized) should be used.

Read More: Nutrition

More Invasive Options:

If topical scar treatments don’t help, there are several more invasive options for people to consider. Dermabrasion is the process of carefully removing layers of skin. It utilizes a series of rotating brushes, which spin quickly across raised tissue to reduce its thickness and rigidity. It’s used most often for facial scars, such as ones left by acne or surgeries.

Tissue fillers are aptly named, with dermatologists injecting the skin with substances like hyaluronic acid or calcium hydroxyapatite. These mimic the effects of collagen and help to redefine the skin’s natural contours. This reduces the appearance of scars, as well as improving their overall textures.

Read More: Dermabrasion

Surgical scar revision can also be a very good option for some problem scars, especially scars that healed poorly or unevenly, and ice-pick acne scars. This of course creates a new scar, but replaces the problem scar with a scar that heals better and more predictably.

Consult With a Board Certified Dermatologist or Plastic Surgeon

Before starting any scar treatment program – whether natural or medical – individuals should consult with a specialist. This will allow them to choose the right products for their particular needs, as well as help them avoid dangerous OTC options (such as hydroquinone or kojic acid). Be aware that no treatment is guaranteed and results will vary based on a patient’s specific scar type, skin type, healing rate, and genetic profile.

Have a question about your old scar? Leave us a comment! Be sure to subscribe to Scars and Spots as well to have all updates delivered right to your inbox.

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How to Bandage a Wound

How to Bandage a Wound

When you have an accident or undergo a surgery, you will be left with a wound to your skin. In order to prevent the wound from causing a larger scar, you need to properly handle how you initially care for it. During the healing stage of the wound, you should keep the area moist by applying an anti-bacterial cream like Neosporin and keep a bandage on the wound to promote the healing of the skin. For the best results, you’ll want to ensure to bandage the wound properly by adhering to the following steps.

Clean The Wound

Before you put on a bandage, you always want to have a clean wound, especially when you initially get hurt. You will want to wait for any bleeding to stop by pressing a clean cloth or piece of gauze to the wound. Then, you should gently clean it with water, although you can also use a saline solution. You want to make sure there is no debris left in the wound. It is OK to use hydrogen peroxide once when cleaning out the wound, but don’t use it again as it will kill the good skin cells along with the bacteria.

Keep The Wound Moist

Before you apply any type of bandage, you should put an anti-bacterial cream on new wounds. This keeps the wound moist, which enhances the natural healing of the wound. It also prevents the bandage from sticking to the wound, which could end up causing more injury when you remove it.

Dress The Wound

You want to use only clean and sterile dressing and bandages. For small wounds, you can use band-aids, but larger wounds may require a larger bandage. If you are making your own bandage, you start with clean gauze or dressing. You cut a piece that covers an area slightly larger than the wound and fold it in half. Then, use medical tape on all four sides of the dressing to keep it securely in place. You want to use medical tape because it will be easier to remove from your skin, while also providing a strong adhesion.

Apply the Bandage

Once the wound is dressed, it is time to apply the bandage around it. This provides extra protection, especially for wounds that are deep and serious or on areas of the body that are difficult to bandage, such as elbows, shoulders, or knees. You can use a cloth strip or ace bandage to cover the area. If you are bandaging a joint area, such as the elbow or knees, you’ll want to cover the area above and below the joint as well to keep it in place. Cover the dressing completely, wrapping the bandage around the area of the body. However, do not wrap the bandage too tightly. Once you have covered the wound, you should secure the bandage using metal clips, safety pins or tape.

You should redress a wound at least once a day. If the dressing becomes wet or dirty, you should always put on a fresh bandage. If you notice the wound is not healing well or it looks infected, be sure to see a doctor. Once the wound has healed, then you can concentrate on reducing the appearance of the scar, including using InviCible Scars.

Have a question about your scar? Leave a comment and we’ll be happy to answer!

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Breast Reconstruction Questions and Answers

Breast Reconstruction Questions and Answers

Oftentimes, women don’t realize (or aren’t told by their doctor) that breast reconstruction is available to them after mastectomy.  The inventor, and doctor, behind InviCible Scars is Dr. Minas Chrysopoulo, who specializes in state-of-the-art breast reconstruction and cosmetic surgery at PRMA Center for Advanced Breast Reconstruction in San Antonio, Texas.

“Dr. C” was named one of “America’s Top Surgeons” and was also a recipient of the San Antonio Business Journal’s “Top 40 Under Forty” Award (2007). Dr C is certified by the American Board of Plastic Surgery, and is also an active member in the American Society of Plastic Surgeons (ASPS), the American Society for Reconstructive Microsurgery, the Plastic Surgery Education Foundation, the San Antonio International Society of Plastic and Reconstructive Surgery, and the Texas Medical Society.

He answered some questions regarding breast reconstruction that we hope you find helpful:

1. What is the most common reason you see women in your practice for breast reconstruction?

– Women recently diagnosed with breast cancer and facing mastectomy

– Women at high risk of breast cancer (eg BRCA+, strong family history) and considering prophylactic mastectomy

– Women that have already completed their breast cancer treatment including lumpectomy or mastectomy, who are now seeking reconstruction or improved breast symmetry.

2. What are some options for breast reconstruction if the patient has had a mastectomy?

There are various options that fall under 2 main types of procedures: those that use the patient’s own tissue to recreate a “natural” breast, or breast implants.

3. Can women expect that their new breasts will look, feel and have the same sensations as before?

That really does depend on the individual situation. If the reconstruction is performed at the same time as the mastectomy, the results can be very good indeed: excellent cosmetic results (some women feel “even better than before” in terms of appearance), and very natural. Reconstructions using the patient’s own tissue tend to create much more natural results than breast implants. Breast implants can also provide very nice results in good candidates.

Delayed reconstruction (reconstruction performed some time after the mastectomy) can also provide very good results, but generally not as good in terms of the final cosmetic result because it usually leaves more scarring.

Unfortunately, it is rare for women to maintain the same level of feeling in their breasts after reconstruction. It is possible for some patients to maintain or regain some feeling but it is typically nowhere near what Mother Nature provided. Some patients are candidates for sensory nerve reconstruction in conjunction with DIEP flap or SIEA flap reconstruction. This reconnects nerves that supply feeling to the breast and allows for improved long term sensation in the reconstructed breast. However, even if this nerve reconstruction is successful, it’s rare for women to regain the sensation they had before the mastectomy.

4. Are there risks associated with breast reconstruction?

Yes. Unfortunately all surgery has risks. The main risk is that the reconstruction doesn’t work which can lead to more surgery.

5. Will there be extensive scarring?

This depends on the procedure the patient chooses. Most procedures that involve using the patient’s own tissue involve scarring on a part of the body other than the breasts (i.e. where the tissue came from.) For example the DIEP flap, today’s gold standard in breast reconstruction, uses the patient’s own abdominal skin and fat to reconstruct a natural, warm, soft breast. The excess lower tummy skin and fat are removed similar to a “tummy tuck”. This provides the patient with the added benefit of a tummy tuck, but also creates additional scarring over the lower abdomen.

These breast reconstruction before and after pictures show the typical scars associated with the procedures performed at PRMA.

Do you have further questions about breast reconstruction that weren’t answered in this post? Leave a comment and Dr. Chrysopoulo will be happy to answer them.

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How to Improve the Appearance of Old Scars

How to Improve the Appearance of Old Scars

Looking at some children nowadays can give us “old” folks a feeling of regret, not for ourselves, but for them. Today’s generation of children is cooped up inside their houses playing with expensive gadgets. Very rarely do you see a child who would prefer to play outside over playing with iPods and video games. Playing inside all the time robs them of a regular childhood where they learn how to fall from a tree or a bike. Some of them  will never know what it’s like to wear “battle scars” like our generation.

Battle Scars

Despite our pride over our childhood scars, vanity has a way of creeping up to you, especially as we grow older. Scars can be a bit of a nuisance especially for women who are fashion-conscious. Short skirts are obviously a no-no for women who have ugly scars on their legs. Yes, despite the happy childhood, there’s nothing pretty about childhood scars.

Hide Scars

The first instinct is to cover up the scars with leggings, jeans and long-sleeved shirts. But then how about those cute little skirts and spaghetti strap dresses? Well, you can always use stockings. Then again, with the unrelenting heat that summer brings, sweaty legs are almost as unpleasant as scarred legs. Makeup is also widely used to conceal scars. It comes in many shades for different skin tones and some are waterproof too. Small, shallow scars are the easiest to conceal with makeup.

Chemical Peels  for Scars

A visit to a reputable dermatologist is the best way to learn about chemical peels. Chemical peels are gaining popularity as a way of fading scars. Peels use certain chemicals to remove the top layer of skin. This “freshens” the look and feel of the skin as well as helping to smooth out and fade the scar. It is non-invasive and has little downtime depending on the strength of the chemicals used. It may take more than one peel to significantly improve the look of the scar, especially if the scar is raised or deep. Chemical peels also have risks. In the short term, peels typically cause some degree of redness. Long term they can cause permanent skin darkening known as “hyperpigmentation” (dark spots). The risk of hyperpigmentation is increased with sun exposure while the skin heals.

Scar Revision Surgery

If scars really bother you, maybe its time to think of a more invasive procedure like scar revision surgery. Consult a reputable plastic surgeon to better guide you in making the best decision. Surgical scar revision involves excising the ugly scar and re-closing it in a more cosmetic way. This can sometimes involve re-arranging some of the tissue to hide the resulting scar even more in a skin crease or shadow. Always be sure to check the fees well ahead of time as surgery is never cheap!

Topical Scar Therapy

Now, not everybody can afford to visit the doctor, surgery is not for everyone and the exuberant fees can be an issue as most medical insurances don’t cover scar revision procedures. A gentler but effective alternative can be to use a topical scar treatment. For regular folks like you and me, it’s the most readily available option. When looking for a product pick one that has proven effective ingredients like Aloe Vera, which has wound healing properties and minimizes inflammation; Vitamin C, which boosts collagen production and promotes skin renewal; Licorice, which lightens dark scars; and Sunflower oil, which can improve scar elasticity and also help lighten it in the process. Although it may take a little more time to get rid of your scars, this is certainly less aggressive than surgery and cheaper too!

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