Scars that cross joints or skin creases at right angles are prone to develop shortening or contractures. They occur when the scar is not fully mature and tend to be hypertrophic. They typically have disabling and dysfunctional properties. They result mostly from burn injuries.
These scars are red, raised and sometimes itchy. Confined to the border of the original surgery or trauma. These scars develop within weeks after surgery and may increase rapidly in size for three to six months and then, after a static phase, begin to regress. They mature to have an elevated, slightly rope-like appearance with increased width. Full maturation can take up to two years.
A focally raised, itchy scar that extends over normal tissue. May develop up to several years after injury and does not regress without treatment. Surgical excision is often followed by recurrence.
Atrophic scars occur as depressed and well-defined lesions. They are usually caused by collagen destruction during the course of an inflammatory condition such as cystic acne or varicella. These scars often have a sunken and pitted appearance.
Children and young adults are prone to vigorous scarring. Elderly people, however, show slower wound closure and slower wound healing rates, therefore they have a reduced risk of abnormal scarring.
Skin type, genetic factors
People with skin types I/II (white, fair, freckles) and V/VI (dark brown, black) are more likely to develop abnormal scars. If you have experienced pathological scarring before or it lies within your family history you may have an increased likelihood of abnormal scar formation.
Scars that cross joints, skin creases or large muscle groups are likely to form abnormal scars, for example, after cesarean sections or after chest and breast surgery.
Scars have a tendency to enlarge during pregnancy and puberty due to the hormonal influence.