If a burn injury damages the reticular dermis, why does long-term skin regeneration often result in hypertrophic scarring rather than complete restoration?

💡 Explanation

Hypertrophic scarring arises because the wound healing process, specifically collagen synthesis, becomes dysregulated after deep dermal burns. This excessive collagen production overwhelms the normal tissue remodeling, therefore, creating raised scars rather than complete regeneration; the imbalance favors synthesis over degradation, rather than keratinocyte overgrowth, elastin excess, or complete fibroblast shutdown.

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