Is it sensible to use chemical peeling to treat my hypertrophic scar? (Photos)

Question

Hello I have this hypertrophic scar that was caused by falling face first on a sharp piece of metal. For some reason, I decided to not get stitches for it, which caused the formation of this scar. The scar is 2 years old now. My derm recommended 4 sessions of chemical peeling. However after doing some research, I can barely find anywhere that recommends chemical peeling as treatment for hypertrophic scars. More commonly sited treatments are knalog injections, and lasers. Do you think I should go ahead with it, thank you Side note: My derm also said that I couldn't use lasers because my skin is too dark for it, and I couldn't get a cortisone injection because the scar is too old.

Anna Chacon, MD, FAAD · Answer

You’re asking a very reasonable question, especially because hypertrophic scars tend to respond in very specific ways—and not all treatments are equally effective depending on the depth, age, and color of the scar and surrounding skin.

In general, chemical peels are not a primary or evidence-based treatment for true hypertrophic scars. Peels mainly work on the epidermis (outer skin layer), improving texture, pigmentation, and surface irregularities. Hypertrophic scars, however, sit deeper in the dermis, where there is excess collagen and thickened scar tissue. Because of that, peels alone usually do not meaningfully flatten or remodel the scar itself.

That’s likely why you’re finding limited literature supporting chemical peels for this purpose—your research is aligned with standard dermatologic practice.

Where chemical peels can sometimes help is in a supportive role, for example:

Improving post-inflammatory hyperpigmentation around the scar
Slightly refining surface texture mismatch between scar and surrounding skin
But they don’t typically reduce the bulk or height of a hypertrophic scar.

Regarding the other treatments you mentioned:

Intralesional corticosteroid injections (like Kenalog / triamcinolone) are usually first-line for hypertrophic scars because they directly reduce collagen overgrowth. Even older scars can still respond, although they may require more sessions or combination therapy rather than dramatic single-session change.
Laser treatments (especially fractional lasers or vascular lasers) are often very helpful, but skin tone matters. In deeper skin tones, the concern is not that lasers are impossible, but that the wrong type or settings can increase risk of pigmentation changes. That said, there are safer laser options designed for darker skin, so it’s not always an absolute contraindication—it depends on device and expertise.
Saying a scar is “too old” for steroid injections is not typically accurate in dermatology. Older scars can be more resistant, yes, but they are not untreatable. We often still see improvement even in 1–5 year old hypertrophic scars, especially with combination approaches.

So, in a situation like yours, chemical peeling alone would generally be considered low-impact for the main problem (scar elevation). It might help the surrounding skin, but it would not usually be expected to significantly flatten the scar itself.

In practice, hypertrophic scars often respond best to a layered approach, rather than a single modality, even when one treatment is limited by skin type or timing.

Is it sensible to use chemical peeling to treat my hypertrophic scar? (Photos)

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