Hypertrophic Scars vs Keloids: The Difference and the Treatments

Scroll through recovery videos from tummy tucks, cesarean births and knee replacements right now and you will see the same ritual: a strip of silicone tape smoothed over a fresh incision, a firm massage with the pad of a thumb, a caption promising that the scar will “disappear.” As of early 2026, searches for raised surgical scars have climbed alongside that content, and so has a tangle of claims about which scars fade, which never do, and whether you can tell in advance.

The confusion has a real medical root. Two kinds of raised scar look alike in the first weeks: the hypertrophic scar, which stays inside the wound’s footprint and usually calms down, and the keloid, which keeps growing past it. Surgeons watch for both because the difference changes everything from the dressing you wear to whether you should expect a second procedure.

Here is what the evidence supports, what it does not, and what to ask before your own surgery date.

What is a hypertrophic scar, and how is a keloid different?

Every wound that reaches the dermis, the thick middle layer of skin, heals by laying down collagen, the rope-like protein that gives skin its strength. In an ideal repair, cells called fibroblasts (the skin’s construction crew) produce collagen for a few weeks, then stop, and the scar flattens into a pale line.

A hypertrophic scar forms when that construction crew works overtime. Collagen piles up faster than the body removes it, producing a raised, firm, pink-to-red ridge. The defining feature is geography: a hypertrophic scar never spills past the borders of the original wound. It typically appears within four to eight weeks of injury, grows for a few months, then slowly regresses, often over twelve to eighteen months.

A keloid is a different biological event, not simply a bigger hypertrophic scar. Here the fibroblasts behave as if the “stop” signal never arrives. The scar extends beyond the wound edges into healthy skin, sometimes forming a dome or a claw-like shape, and it can keep enlarging for years. Keloids are frequently itchy or tender, rarely shrink on their own and have a strong habit of returning after they are cut out. Mayo Clinic and MedlinePlus both describe keloids as more common on the chest, shoulders, upper back, earlobes and jawline, areas where skin sits under constant tension or where piercings and acne create repeated small injuries.

The distinction matters because the two conditions follow different timelines and respond differently to treatment. A hypertrophic scar often rewards patience and conservative care. A keloid usually needs a clinician’s plan and realistic expectations about control rather than disappearance.

Keloid vs hypertrophic scar: the signs that tell them apart

In the clinic, the question “keloid or hypertrophic?” is answered mostly with eyes, hands and a calendar. No blood test separates them, and a biopsy is reserved for scars that behave unusually. Five clues carry most of the weight.

Feature	Hypertrophic scar	Keloid
Borders	Stays within the original wound	Grows beyond the wound edges
Timing	Appears within 1–2 months of injury	May appear months, even a year, later
Natural course	Usually flattens over 12–24 months	Rarely regresses; may enlarge for years
Common sites	Joints, burns, any incision under tension	Chest, shoulders, earlobes, upper back, jaw
After surgical removal	Recurrence uncommon with good technique	Recurrence frequent without added therapy
Symptoms	Mild itch, tightness	Itch, tenderness, sometimes pain

The border rule is the one to memorize. Run a finger along the scar: if the raised tissue tracks exactly where the cut or burn was, it is almost certainly hypertrophic. If it has crept sideways onto skin that was never injured, keloid moves to the top of the list. The NHS makes the same point in plain terms, describing keloids as scars that “grow beyond the original area of skin damage.”

Timing adds a second check. Hypertrophic scars announce themselves early; keloids can arrive late, sometimes after a wound looked fully healed. Location adds a third. A raised scar on an earlobe after a piercing is far more likely to be a keloid than one across the knee after a fall.

Family history, skin tone and the scar’s behavior over months complete the picture. When a clinician is unsure, the honest answer is often “let’s watch it for a few months,” because the course of the scar is itself the best diagnostic test.

What causes scars to hypertrophy?

The short answer is prolonged inflammation plus mechanical tension. The longer answer is a healing process that overshoots.

Normal wound repair runs in three overlapping phases. Inflammation clears debris in the first days. Proliferation, from roughly day three to week three, fills the gap with new blood vessels and collagen. Remodeling, which can last a year or more, swaps the hastily laid type III collagen for stronger, better-organized type I collagen and trims the excess. A hypertrophic scar develops when the proliferation phase runs long and the remodeling phase lags.

Several conditions push healing in that direction, and they are worth knowing before an operation:

• Tension across the wound. Incisions that cross joints, the sternum or the shoulders are pulled apart with every movement. Fibroblasts sense that stretch and respond by producing more collagen.
• Delayed closure. Burns and wounds that take longer than about two to three weeks to close are far more likely to thicken. Cleveland Clinic notes that deep burns are among the strongest triggers.
• Infection or repeated irritation. Each flare of inflammation restarts the collagen signal.
• Depth of injury. Scrapes confined to the epidermis heal without hypertrophy; wounds that reach the deeper dermis carry the risk.

Keloids share these triggers but add a genetic layer. They cluster in families and are reported more often in people of African, Asian and Hispanic ancestry, with some population studies describing rates many times higher than in people with lighter skin. Hormonal shifts during puberty and pregnancy appear to make keloid formation more likely, which fits the observation that keloids most often begin between the ages of ten and thirty.

None of these factors guarantees a problem scar. They shift probabilities, which is exactly why surgeons ask about them during pre-operative visits.

Preparing for surgery: who is most at risk for a hypertrophic scar?

Surgeons cannot promise an invisible scar, but they can predict, with reasonable accuracy, who is likely to develop a thick one. The pre-operative conversation should cover four areas.

Your scar history. The single most useful predictor of a future hypertrophic scar or keloid is a past one. Bring up any raised scar, including ones from acne, chickenpox, vaccinations or ear piercings. A keloid on an earlobe, even a small one, is a meaningful signal.

Family history. Keloids run in families strongly enough that a parent or sibling with one should be mentioned. Hypertrophic scarring has a weaker inherited component but still clusters.

Skin tone and age. Darker skin and age under about thirty are both associated with higher rates of keloid formation in observational studies. Older adults scar more thinly, partly because collagen production slows with age. This is a biological observation, not a judgment, and it helps clinicians plan prevention.

The operation itself. Location and tension matter more than size. A long incision along a natural skin fold on the abdomen often heals more quietly than a short one across the breastbone. Procedures involving the chest wall, shoulders, upper back and ears carry the highest keloid risk; incisions crossing joints carry the highest hypertrophic risk because of movement.

Medical factors round out the picture. Poorly controlled diabetes, smoking and poor nutrition all slow wound closure, and anything that prolongs healing beyond a few weeks raises the chance of a thickened scar. Some surgeons will ask about these weeks ahead so that blood sugar, smoking status and protein intake can be addressed before the date.

If several risk factors line up, the surgical team may plan prevention from day one: incision placement along relaxed skin tension lines, layered closure that takes stress off the skin surface, early silicone, and in high-risk keloid cases, a scheduled follow-up to catch early thickening while it is still responsive.

What changed recently

The science of problem scars moves slowly, but a few shifts explain why the topic is crowding search results as of early 2026.

Scar prevention has moved into mainstream patient education. Within the past several years, the major consumer health references cited in this article (Mayo Clinic, Cleveland Clinic, MedlinePlus and the NHS) have all updated their scar pages to emphasize early prevention after surgery rather than treatment of an established scar. Silicone sheets and gels, once a plastic-surgery niche, are now routinely listed as a first step for anyone at risk, and the NHS keloid guidance explicitly names them alongside pressure and steroid injections.

The treatment conversation has shifted toward combinations. Older advice often described keloid care as a single choice: injections or surgery. Current guidance, including Mayo Clinic’s keloid overview, frames the problem as one where surgery alone has a high recurrence rate and is best paired with another measure, such as injections, pressure or radiation delivered immediately after excision. That framing reflects observational studies accumulated over the past decade rather than one landmark trial.

New biology, still investigational. Laboratory work has reframed keloids as a disorder of inflammatory signaling, not just excess collagen. That has prompted small case series testing immune-targeted medicines originally approved for other skin conditions. These uses remain off-label and unproven; the decision to consider any of them belongs to a treating dermatologist or surgeon, and nothing in that category is appropriate for self-use or purchase outside clinical care.

The social media effect. The most visible change is cultural. Short videos documenting post-surgical scar care have made silicone tape and scar massage familiar to millions of people. That awareness is mostly welcome. The trade-off is a stream of overconfident claims, which the myths section below addresses directly.

What the evidence actually says, graded honestly

Scar research is harder than it looks. Scars take a year or more to declare themselves, every wound is different, and “better” is partly in the eye of the beholder. The result is a field where a few treatments rest on randomized trials, more rest on observational data, and a surprising amount rests on expert consensus.

Silicone sheets and gels: moderate, imperfect evidence. Multiple randomized trials and systematic reviews suggest silicone reduces the height and redness of hypertrophic scars and may lower the chance of one forming after surgery. Reviewers consistently note that many of these trials were small and at risk of bias. The honest summary: probably helpful, low risk, not a guarantee.

Corticosteroid injections: strong real-world track record, modest trial base. Injecting a corticosteroid, an anti-inflammatory medicine, directly into a scar (an “intralesional” injection) is the longest-established treatment for keloids and stubborn hypertrophic scars. Decades of clinical experience and several small trials show flattening and relief of itch in most treated scars. Recurrence after stopping is common, and side effects such as skin thinning and lightening are well documented.

Pressure therapy: moderate evidence, mainly in burns. Randomized trials in burn patients show pressure garments reduce scar thickness, with effect sizes that are real but smaller than early enthusiasm suggested.

Laser and light therapy: growing but small trials. Vascular lasers that target the blood vessels feeding a red scar reduce redness and may soften texture. Most studies are small, with short follow-up.

Surgery with adjuvant therapy for keloids: observational data. Cutting out a keloid alone leads to recurrence in a large share of cases, often cited as roughly half or more. Adding injections, pressure or radiation after excision appears to lower that rate substantially, but the comparisons come from cohort studies rather than large randomized trials.

Cryotherapy, onion-extract gels, vitamin E oil: weak or negative evidence. Freezing can shrink small keloids, with pigment loss as a trade-off. Over-the-counter botanical gels and vitamin E have not outperformed plain moisturizer in controlled studies.

Can a hypertrophic scar go away, and do hypertrophic scars go away on their own?

This is the question behind most searches, so it deserves a precise answer. A hypertrophic scar frequently improves dramatically without any treatment, and many flatten to the point where only a pale line remains. “Go away” in the sense of leaving no trace is rarer; some mark almost always persists where the dermis was cut. But the raised, red, tight phase is usually temporary.

The timeline is longer than most people expect. A typical hypertrophic scar thickens over the first three to six months, plateaus, then begins to soften. Redness fades as the extra blood vessels that fed the healing wound close down, which is why a scar that looked angry at four months can look unremarkable at eighteen. Cleveland Clinic describes this regression as the normal course, though it can take up to two years or occasionally longer.

Three things influence how far a hypertrophic scar flattens:

• Tension. Scars across joints or on the chest flatten least, because they are stretched daily.
• Depth and duration of the original wound. Deep burns that took weeks to close leave thicker, slower-resolving scars than a clean surgical incision.
• Early intervention. Silicone and pressure in the first months appear to speed and improve the natural flattening, based on moderate-quality trials.

Keloids are the exception that proves the rule. A keloid does not reliably regress; left alone, many stay stable for years and some enlarge. If a scar is still growing at twelve months, has crossed the wound edges or is becoming more painful rather than less, it is probably not following the hypertrophic timeline and deserves an evaluation.

Patience is a legitimate medical strategy for a hypertrophic scar. It is not one for a keloid.

Hypertrophic scar treatment: what clinicians actually use

Because hypertrophic scars tend to improve on their own, treatment aims to speed that process, relieve itch and tightness, and limit the final height. Clinicians generally work from least invasive to most.

Silicone. Thin sheets or a gel that dries into a film are worn over the healed scar for most of the day for several months. The leading theory is that silicone hydrates the top layer of skin and moderates the signals that drive fibroblasts, though the exact mechanism remains debated. It is safe on healed skin and is usually the first recommendation after sutures are out.

Pressure. Custom garments or firm dressings compress the scar, limiting blood flow and collagen production. This is the standard of care after significant burns and is sometimes used on surgical scars over large areas.

Scar massage and stretching. Gentle, firm massage once the wound has sealed may improve pliability and reduce itch. The trial evidence is thin and mostly from burn rehabilitation, but the practice is low risk and widely recommended by surgical teams.

Corticosteroid injections. For a hypertrophic scar that remains thick, itchy or painful beyond the expected window, an injected corticosteroid can flatten it and calm symptoms. The clinician chooses the medicine, the amount and the interval; the trade-offs include thinning or lightening of surrounding skin.

Laser. Vascular lasers reduce redness; fractional lasers, which create tiny controlled injuries, can soften texture over several sessions.

Surgical revision. If a hypertrophic scar is caused by tension or poor alignment, a surgeon may re-cut and re-close it along a better line, often combined with silicone or injections afterward. Unlike keloids, revised hypertrophic scars usually do not recur if the underlying tension problem is solved.

Choosing among these is a clinical judgment based on the scar’s age, location, symptoms and your goals, which is why a conversation with the treating clinician beats any product label.

How keloid treatment differs from hypertrophic scar treatment

Keloids require a mindset shift: the goal is control and comfort, not a scar-free outcome. Every mainstream guide, from MedlinePlus to the NHS, is candid that keloids frequently return and that no single treatment works for everyone.

Corticosteroid injections remain the backbone. They are the most widely used first-line treatment for keloids, usually repeated at intervals the clinician sets, and they reliably reduce itch and tenderness while flattening the scar in most people. The scar often remains visible and may re-thicken after the series ends.

Surgery is a last step, not a first one. Cutting out a keloid without any follow-up measure invites a larger keloid in the same place, because the surgery is itself a new wound in skin that has already shown it over-heals. For this reason, excision is nearly always paired with something else: injections started at the time of surgery, pressure devices such as clip earrings for earlobe keloids, or radiation therapy delivered to the wound bed in the days after excision. Observational data suggest these combinations cut recurrence substantially.

Cryotherapy. Freezing the keloid, either from the surface or through a probe inserted into the scar, can shrink smaller lesions. Lightening of the treated skin is a frequent side effect, which matters most in darker skin tones.

Laser. Used mainly to reduce redness and itch, often alongside injections rather than alone.

Silicone and pressure. Helpful for maintenance and prevention after other treatments, less likely to shrink an established keloid by themselves.

The NHS also raises a point patients rarely hear: for someone with a known tendency to keloids, avoiding elective skin injury such as piercings, tattoos and non-essential cosmetic procedures is a legitimate prevention strategy. When surgery is necessary, telling the surgeon in advance allows a prevention plan to be built into the operation itself.

What to ask your surgeon before the operation

A ten-minute conversation before surgery can shape a scar for life. These questions put the evidence to work.

• “Where exactly will the incision be, and can it follow a skin fold or natural tension line?” Incisions placed along the lines where skin naturally relaxes are under less stress and thicken less.
• “How will you close the deeper layers?” Layered closure, where stitches below the surface take the strain, leaves the skin edges resting together rather than pulling apart.
• “Given my history, do you expect a hypertrophic scar or keloid risk, and what is the prevention plan?” Mention every raised scar you have ever had, your family history and your skin tone concerns. A surgeon who hears “my brother has a keloid on his chest” before a chest procedure can plan differently.
• “When can I start silicone, and for how long?” Most teams start once the wound is fully sealed and sutures are removed, then continue for months.
• “What should the scar look like at one month, three months and a year?” Knowing the expected arc keeps you from panicking at the three-month peak, and alerts you if the scar is behaving abnormally.
• “Who do I call if it thickens, itches badly or grows past the edges?” Early thickening is far easier to treat than a mature keloid.

It also helps to be honest about habits that slow healing. Smoking narrows blood vessels and starves the wound of oxygen; many surgeons ask patients to stop for weeks before and after an operation. Blood sugar outside the target range delays closure. Adequate protein and calories supply the raw material for repair. None of this is scar-specific advice, but anything that shortens healing time lowers the odds of a thickened scar, because a wound closed in ten days behaves very differently from one still open at four weeks.

Wound care in the first weeks: where scars are won or lost

The behavior of a scar is largely set in the first six to eight weeks, when the proliferation phase is deciding how much collagen to lay down. Good care during this window is not glamorous, but it is where the evidence is clearest.

Keep the wound closed and clean. Follow the surgical team’s instructions on dressings and bathing. A wound that reopens or becomes infected restarts inflammation and raises the risk of a hypertrophic scar. Signs of infection, covered in the doctor section below, warrant a same-day call.

Protect from tension. Surgeons often ask patients to limit stretching of the incision area for several weeks. Paper tape placed along a healed incision line is a low-tech way to take strain off the skin, and small trials suggest it may reduce scar width and thickness. Ask before using it, since adhesive can irritate fragile new skin.

Shield from the sun. New scars lack the pigment-regulating cells of mature skin and darken easily with ultraviolet exposure. Covering the scar or using sunscreen once the skin has sealed, for at least the first year, reduces the risk of a permanently darker mark. This is one of the few scar recommendations with little downside and broad agreement.

Start silicone when cleared. Once the wound is fully epithelialized, meaning a continuous layer of new skin covers it, silicone can begin. Applying any product to an open or weeping wound invites irritation and infection.

Massage gently, later. Firm, slow pressure along the scar once it has sealed may improve flexibility. Pain, bleeding or opening of the edges means it is too early.

Watch, with dates. A photo at two weeks, six weeks, three months and six months, taken in the same light, is more useful than memory. It lets you and your clinician see whether the scar is following the expected hypertrophic arc, peaking and then softening, or creeping beyond its borders.

Common myths about hypertrophic scars and keloids

Viral scar content is a mix of good habits and confident nonsense. Here is where the evidence parts ways with the captions.

Myth: vitamin E oil fades scars. Controlled studies have found no benefit over plain moisturizer, and a notable minority of people develop contact dermatitis from topical vitamin E, which can make a healing scar worse. Keeping a scar moisturized is reasonable; the specific oil is not the magic.

Myth: a keloid is just a hypertrophic scar that got out of hand. They are distinct processes with different genetics, timelines and recurrence patterns. A hypertrophic scar does not transform into a keloid over time; it was one or the other from the start, even if early appearance made that hard to call.

Myth: cutting a keloid out solves the problem. Surgery alone is one of the more reliable ways to produce a larger keloid. Excision is useful only as part of a combined plan.

Myth: if a scar is still red at six months, something went wrong. Redness commonly persists for a year or more as the extra blood vessels from healing slowly close. Redness alone, without growth or symptoms, is usually part of the normal course.

Myth: scar massage can “break up” a keloid. Massage may improve pliability and itch in hypertrophic scars. It does not dissolve a keloid, and aggressive rubbing can irritate it.

Myth: dark-skinned people cannot have laser treatment. Certain lasers carry higher pigment risks in darker skin, and settings must be chosen carefully, but experienced clinicians treat scars across all skin tones. The right question is which device and which operator, not whether.

Myth: over-the-counter “keloid removers” work. Topical products have not been shown to remove keloids in any controlled study. Anything promising removal from a bottle is marketing, not medicine.

Living with itch, pain and the scar you did not choose

Medical articles tend to treat scars as a cosmetic footnote. For the person wearing one, the lived reality is often itch that wakes you at night, tenderness against a seatbelt or bra strap, and the quiet calculation of what to wear.

Itch is the most common complaint in both hypertrophic scars and keloids, and it has a mechanism: regenerating nerve fibers and inflammatory chemicals in the scar send signals the brain reads as itch, while the scar’s lack of oil glands leaves it dry. Moisturizing, silicone and cool compresses help many people. Corticosteroid injections typically relieve itch within days even when the scar remains raised, and for some patients that symptom relief is the main reason to treat. Oral antihistamines are sometimes suggested by clinicians for night-time itch; whether they are appropriate is a decision for your prescriber.

Pain and tightness matter most when a scar crosses a joint. A hypertrophic scar over a knee or elbow can limit range of motion as it matures, a problem called contracture, where shortened scar tissue pulls the joint toward a bent position. Early stretching guided by a physical or occupational therapist, pressure and silicone can prevent this, and established contractures sometimes need surgical release.

The psychological weight is real and under-discussed. Visible scars, especially on the face, neck and chest, are associated in observational studies with lower self-reported quality of life, and keloids carry the extra frustration of recurrence. Talking honestly with a clinician about which treatments can realistically change the appearance, and which cannot, tends to help more than any single procedure. Scar camouflage techniques, including medical tattooing to even out color, are options some dermatology and plastic surgery teams offer once a scar is mature and stable.

A scar is a record of healing. For most hypertrophic scars, that record fades considerably. For keloids, learning what keeps them quiet is the realistic and worthwhile goal.

When to see a doctor about a hypertrophic scar or keloid

Most raised scars can be monitored at routine follow-up visits. Some deserve a prompt appointment, and a few should be evaluated the same day.

Call the surgical team or seek care the same day if a healing wound shows:

• Spreading redness, increasing warmth or swelling around the incision
• Cloudy or foul-smelling drainage
• Fever or chills
• Wound edges pulling apart or a gap opening after it had sealed
• Rapidly increasing pain

These are signs of infection or wound breakdown, and treating them quickly protects both your health and the final scar.

Book an appointment within a few weeks if an established scar:

• Grows beyond the original wound edges, which suggests a keloid rather than a hypertrophic scar
• Is still enlarging after twelve months instead of softening
• Becomes increasingly itchy, tender or painful over time
• Restricts movement at a joint, or feels like it is pulling the skin tight
• Darkens significantly or develops uneven color

Do not wait if a long-standing scar changes character: a scar that breaks open and will not heal, bleeds without injury, develops a lump within it or changes texture after years of stability needs examination. Persistent non-healing in an old scar is uncommon but occasionally signals something other than scar tissue, and a clinician may recommend a biopsy to be sure.

Every treatment described in this article, from silicone to injections to surgery, involves trade-offs that depend on your skin, your history and your goals. The choice of approach, the specific medicines used and how often they are given belong to the dermatologist or surgeon who can examine the scar in person. If you are already using a prescribed treatment, do not stop or change it based on something you read online; raise the question at your next visit instead.

Bring photographs with dates. They turn a vague “it seems bigger” into evidence a clinician can act on.

Frequently asked questions

Can a hypertrophic scar go away completely?

A hypertrophic scar usually flattens and fades substantially, but it rarely vanishes without a trace. The raised, red phase is temporary in most people and resolves over twelve to twenty-four months, leaving a paler, flatter line. Scars under tension, such as those across joints or the chest, tend to retain more height. Early silicone and pressure may improve the final result.

How can I tell the difference between a keloid vs hypertrophic scar at home?

Check the borders first: a hypertrophic scar stays exactly where the wound was, while a keloid spreads onto surrounding healthy skin. Timing helps too; hypertrophic scars appear within a couple of months, keloids can arrive much later. Location adds a clue, since earlobes, chest and shoulders favor keloids. If the scar is still growing after a year, see a clinician.

What causes hypertrophic scars to form after surgery?

Prolonged inflammation and tension across the wound are the main drivers. When healing is delayed by infection, poor blood supply or a deep injury, fibroblasts keep producing collagen longer than needed. Incisions that cross joints or sit on the chest are pulled with every movement, which further stimulates collagen. Younger age and a personal or family history of raised scars raise the odds.

Do hypertrophic scars ever flatten without treatment?

Yes, flattening is the expected course. A hypertrophic scar typically thickens over the first few months, plateaus, then slowly softens as excess collagen is remodeled and extra blood vessels close down. The process can take up to two years. Treatment aims to speed and improve that natural flattening, not to force something the body would never do on its own.

What is the most effective hypertrophic scar treatment?

No single option wins for everyone, but silicone sheets or gel are the usual first step, backed by moderate-quality trials showing reduced height and redness. Pressure therapy is standard after burns. For scars that stay thick, itchy or painful, corticosteroid injections chosen and administered by a clinician have the longest track record. Laser and surgical revision are reserved for selected cases.

Will a keloid come back after surgery?

Often, if surgery is used alone. Excising a keloid creates a new wound in skin that has already shown a tendency to over-heal, and recurrence rates are high in that scenario. Combining removal with corticosteroid injections, pressure devices or radiation therapy immediately afterward appears to lower recurrence substantially, based on observational studies. Your surgeon will discuss which combination fits your case.

Does scar massage help a hypertrophic scar?

Gentle, firm massage once the wound has fully sealed may improve pliability and ease itch, and surgical teams commonly recommend it. The trial evidence is limited and comes mostly from burn rehabilitation, so treat it as low-risk and plausibly helpful rather than proven. Massage does not dissolve a keloid, and rubbing an irritated or open wound can make matters worse.

Are people with darker skin more likely to get keloids?

Observational studies consistently report higher keloid rates in people of African, Asian and Hispanic ancestry compared with people with lighter skin, and keloids often run in families. This reflects genetic differences in how skin regulates healing, not anything a person did wrong. It is useful information for surgical planning, because prevention can be built into an operation when risk is known in advance.

Can I prevent a hypertrophic scar before surgery?

You can lower the odds. Tell your surgeon about any past raised scars and family history, ask about incision placement along natural skin lines and layered closure, and address healing risks such as smoking and blood sugar beforehand. After surgery, keep the wound clean, limit tension, protect it from sun and start silicone once the skin has sealed and your team gives the go-ahead.

When does a raised scar become a medical concern?

Seek same-day care for spreading redness, warmth, drainage, fever or a wound reopening, which point to infection. Book an appointment if a scar grows beyond the wound edges, keeps enlarging after a year, becomes increasingly painful or restricts a joint. A long-stable scar that breaks open, bleeds or develops a lump should be examined promptly to rule out other causes.

References

• MedlinePlus Medical Encyclopedia: Keloids
• NHS: Keloid scars
• Cleveland Clinic: Hypertrophic Scar

This article is for general information only and is not a substitute for professional medical advice. Please consult a qualified doctor about your individual situation.