Hypertrophic Scar

Patient: Hi DocI was in a car accident about 15 years ago which has caused scarring in my facial area. about 3 years ago i had surgery removing a cyst in my face. Few weeks after the cyst scar hed healed the ols scars starting to lift and turned dark reddish.Which I believe is hypertrophic scarring. I have used all different kind of oils and ointments and none of was working like it suppose to.My question is:1.What could have caused this hypertrophic scarring, because i have never had this problem before?2. What is the best possible treatment for this

Doctor: Thank you for your question.It is possible that you have developed hypertrophic scars during the healing of your cys t removal. Fortunately, there are many options for the treatment of hypertrophic scars. The single handed most efficacious treatment is the injection of a corticosteroid called triamcinolone (kenalog) directly into the scar. This acts over the course of 6 weeks and may require several injections to achieve a flat scar. Any plastic surgeon can perform this injection in an office setting and poses minimal risk. If you have darker color skin, there is a risk of skin hypopigmentation (lightening) in the area of injection that should be discussed with your doctor.Silicone gel sheeting has also shown promise in the reduction of hypertrophic scars. I would also recommend daily massaging of the scars after the steroid has been injected. This will help the collagen fibers to be broken up and reorganized in a linear fashion.