Skin Graft Keloid Scars: What to Know

A skin graft repairs or covers an area where skin has been lost. During healing, scar tissue can become thick, firm, raised, itchy, tender, or darker than nearby skin. A keloid extends outside the wound or graft edge, while a hypertrophic scar generally remains within it. The graft itself may be healthy even when the scar around it is overgrown. A clinician will examine the scar and ask whether it is enlarging, rubbing against clothing, restricting movement, or causing discomfort. A new lump is not automatically a keloid; a persistent or changing lesion deserves an examination.

Arrange a dermatology or surgical review if the scar is expanding, painful, itchy, or interfering with the grafted area. Do not cut, puncture, or repeatedly irritate it at home. Keep the site protected from friction and follow the wound-care plan supplied after graft surgery. Possible clinician-led options include steroid injections into the scar, laser treatment, freezing treatment, or surgery; keloids can return after removal, so prevention and follow-up may be part of the plan. Treatment choice depends on the scar's thickness, location, symptoms, and previous response.

Contact the treating team promptly for spreading redness, increasing warmth, pus, wound separation, fever, bleeding that does not settle with gentle pressure, or rapidly worsening pain. Seek urgent care for severe swelling, marked colour change, or feeling very unwell. These signs can point to infection, bleeding, or a graft problem rather than ordinary scar thickening.

Ask whether the scar stays within the graft boundary or extends beyond it, whether treatment is needed now, how recurrence will be reduced, and which symptoms should trigger an earlier review. Ask how to protect the graft during injections, laser sessions, or any procedure.