Hypertrophic scars are primarily caused by thermal damage to the reticular layer of the dermisDermis (Ogawa R, Int J Mol Sci 18(3):606, 2017). This deep dermal injury initiates wound-healing responses, including the early inflammatory stage. However, the inflammatory stage can be aberrantly prolonged by various factors. The resulting chronic inflammation activates wound fibroblasts, which lay down excessive amounts of extracellular material, thereby inducing scar growth. A key inflammation-exacerbating factor that leads to post-burn hypertrophic scarring is sustained/repetitive mechanical tension on the wound/scar. This explains why hypertrophic scars are particularly severe at specific anatomical sites, notably the anterior chestAnterior chest, anterior neckNeck, elbow joint, dorsal handHand, and fingers: these regions typically experience considerable skin stretching due to routine bodily movements. Conversely, hypertrophic scarringScarring is less common and less severe on the anterior lower legLower leg, where the skin overlies bone with minimal subcutaneous fatFat and is subjected to less tensile stress. These observations suggest that minimizing mechanical stress on healing wounds and thus allowing the wounds to rest could help reduce inflammation and thereby prevent hypertrophic scarring.