Keloid and Hypertrophic Scars

A keloid scar refers to a firm, smooth, and hard growth that results from spontaneous scar formation. It can appear immediately after an injury or take a few months to fully develop. Keloids may be uncomfortable or itchy, and they can extend beyond the original wound site. They may form anywhere on the body, but the upper chest and shoulders are affected the most.

The reasons why wound healing sometimes leads to the formation of a keloid scar have not yet been discovered.

While the majority of the general population will never develop keloids, others can develop them after minor injuries, acne spots, burns, and insect bites. Individuals with dark skin develop keloids more readily in comparison with individuals who have fairer skin.

A keloid is considered to be harmless to general health and does not develop into skin cancer.

As a wound heals, scar tissue begins to form. Initially, it appears as a red and often prominent lesion. After several months, the scar becomes pale and flat. However, if there is considerable tension on a healing wound, the healing area may become thicker than usual. This condition is referred to as a hypertrophic scar. A hypertrophic scar is limited to the damaged skin site.

A hypertrophic scar is able to resolve over time or, in some cases, may require treatment. A keloid scar, by contrast, may persist and tends to be resistant to treatment.

Treatment Options

There are several general measures that may be helpful for some patients. Keloid and hypertrophic scars are often treated with various emollients, such as creams and oils. Additional options include polyurethane or silicone scar reduction patches, silicone gel, and pressure dressings. Scar dressings are required to be worn for 12 to 24 hours per day for a minimum of 8 to 12 weeks.

Cryotherapy may also be used as a treatment method. The procedure involves freezing the scar tissue in order to destroy cells responsible for keloid scar formation. Surgical excision may be beneficial in some cases; however, due to the nature of keloids, excision may stimulate the formation of new keloids that are larger than the original.

Intralesional steroid injection is another available treatment option. This injection involves the use of a corticosteroid, such as triamcinolone acetonide, which is injected directly into a lesion on or just below the skin. This procedure is typically repeated every few weeks.