Treatment of Hypertrophic Scars and Keloids

A hypertrophic scar stays within the boundary of the original wound and may gradually become flatter. A keloid grows beyond that boundary and can continue enlarging. Either may feel firm, itchy, tender or tight, and both can affect movement when they cross a joint. Examination helps distinguish scar tissue from an active skin problem and identifies whether friction, an earring, an operation or another injury contributed.

A clinician may begin with an [Steroid Injection Into The Skin](/treatments/injectables/intralesional-steroid-injection/) to soften and flatten selected scars. [Fractional Laser Treatment](/treatments/laser-and-energy/fractional-laser-treatment/) may improve texture or help other treatment reach the scar, but the plan depends on skin type and location. Surgery, including [Surgical Excision](/treatments/surgical-dermatology/excisional-surgery/) or [Scar Revision Surgery](/treatments/surgical-dermatology/scar-revision-surgery/), is considered cautiously because a new raised scar can form. Silicone-based wound care and protection from rubbing may support the plan when advised.

Book an assessment if a scar is enlarging, painful, itchy, bleeding, restricting movement or repeatedly irritated. Seek prompt review for warmth, drainage, sudden tenderness or spreading redness, which may suggest infection rather than stable scar tissue. Earlier assessment is useful when a raised area appears soon after an injury or procedure.

Ask whether the scar is hypertrophic or a keloid, what outcome is realistic, how many treatment visits may be needed, and how recurrence will be monitored. Discuss your previous scarring history, skin tone, treatment risks and the best aftercare for the proposed procedure.