Close-up image of a hypertrophic scar on a person's shoulder. The scar is raised, bumpy, pinkish in color, and appears to be healing. The surrounding skin looks normal, with small patches of dry skin visible near the scar.

What is the difference between hypertrophic and keloid scarring?

Hypertrophic scars are thick, raised scars that are due to overproduction of collagen within a wound. This type of scarring is related to an overresponse to the original trauma or injury. They tend to be more common in scars that become infected or inflamed. Hypertrophic-type scars can also come from wounds that are under a lot of tension or were not closed with sutures when needed. They do not grow beyond the boundaries of the original injury. Hypertrophic scars can occur on any part of the body. Hypertrophic scars develop in all skin types.

Keloid scars are similar but are not the same thing as hypertrophic scars. Keloid scars are also an abnormal response to injury, but these thick, raised scars can grow outside the boundaries of the original injury. They may continue to grow over time. Keloid scarring tends to form on the earlobes, shoulders, cheeks and chest. Keloids are usually more common in patients with darker skin.

Hypertrophic and keloid scar prevention:

  • Pressure Dressings – this will make it more difficult for the scar to become elevated.

  • Silicone gel pads – these have shown promise in preventing keloids from growing and are best when started at the first sign of keloid scar formation. You will need to treat daily for up to 3 months.

  • Sutures – if a wound needs sutures it is best to get the wound closed by a physician. Correct closure will decrease the risk of a hypertrophic scar forming.

Raised Scar Treatments

  • Steroid Injections – this can benefit both keloid and hypertrophic scars. Scar steroids will require injections once a month until the desired improvement occurs.

  • Cryosurgery – This may be beneficial along with the injection of steroids to decrease the bulk of the hypertrophic or keloid scars.

  • Fractional Lasers – Fractional lasers like the DeepFX or ProFractional Laser can be beneficial to decrease the height and firmness of hypertrophic scars. Fractional lasers may also be beneficial for keloids when a strong steroid, such as Clobetasol for scars, is applied following the laser or microneedling treatment. This will decrease the firmness as well as the height of the scars.

  • Microneedling – The Collagen PIN is similar to using fractional lasers and can be less costly for both hypertrophic and keloid scars.

  • Ablative lasers – This should only be used on smaller scars to level them out with the skin. Lazaderm® uses the erbium laser as it is less traumatic to the skin. The CO2 lasers induce more trauma and may lead to more scarring.

  • Surgical Excision – this is possible for the removal of hypertrophic scarring or smaller keloids. Keloids have a high incidence of reoccurring after surgical excision. It is very important to wait at least 1 year following the development of a keloid and to watch the surgical site for keloid formation following surgical excision. It is best to start injecting a steroid into the injury as soon as keloid formation begins.

Get Raised Scar Treatment at Lazaderm®

If you have scarring like a hypertrophic scar on your finger or a keloid scar on your chest, Lazaderm® can help. Our advanced raised scar treatments and our experienced team of aesthetic experts will decrease the size of your scar. Contact our team today for a free consultation to get started on your healing journey.

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