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Updated: Jul 28, 2026

In Vitro Model of Human Cutaneous Hypertrophic Scarring using Macromolecular Crowding
Published on: May 1, 2020
Currently known risk factors for hypertrophic skin scarring: A review
L Butzelaar1, M M W Ulrich2, A B Mink van der Molen3
1Department of Plastic, Reconstructive and Hand Surgery, VU University Medical Center, Amsterdam, The Netherlands.
Objective:
The study aims to provide an overview of risk factors for hypertrophic scarring.
Background:
Hypertrophic skin scarring remains a major concern in medicine and causes considerable morbidity. Despite extensive research on this topic, the precise mechanism of excessive scarring is still unknown. In addition, the current literature lacks an overview of the possible risk factors in the development of hypertrophic scars.
Methods:
PubMed searches were performed on risk factors for hypertrophic scar (HTS) formation.
Results:
Eleven studies suggesting nine factors associated with HTS formation were found. Studies concerning chemotherapy, age, stretch, infection, and smoking have a moderate to high strength of evidence, but some other factors have not been studied in a convincing manner or are still disputed.
Conclusions:
Risk factors for HTS formation are young age, bacterial colonization, and skin subjected to stretch. Chemotherapy, statins, and smoking seem to play a protective role in HTS formation.
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