Some scars don’t fade quietly. Instead of flattening over time, they stay raised, firm, or continue to grow beyond what you expected. When that happens, it can be confusing and, for some people, uncomfortable or frustrating.
Hypertrophic and keloid scars are not dangerous, but they behave differently than typical scars. Understanding what type of scar you’re dealing with is an important first step toward deciding whether treatment makes sense.
Raised scars from overactive healing response
Any injury site; keloids common on ears, shoulders,
Flatter, softer scars with improved comfort
What Are Hypertrophic and Keloid Scars?
Hypertrophic and keloid scars are types of raised scars caused by an overproduction of collagen during the healing process. While they may look similar, they behave differently.
Hypertrophic scars:
Keloid scars:
Both types can appear thick, firm, and raised above the skin surface. They may be pink, red, darker than the surrounding skin, or slightly shiny.
Why These Scars Develop
These scars form when the body’s healing response becomes overactive, producing excess collagen at the wound site.
Contributing factors include:
Genetics — Keloid scars, in particular, tend to run in families. If family members have keloids, you may be more prone to developing them.
Skin type — Keloids are more common in patients with darker skin, though hypertrophic scars develop in all skin types.
Location of injury — Certain areas (earlobes, shoulders, chest, cheeks) are more prone to keloid formation.
Tension on the skin — Wounds under a lot of tension during healing are more likely to develop hypertrophic scars.
Wound closure — Wounds that were not closed with sutures when needed may be more prone to hypertrophic scarring.
Inflammation or infection — Scars are more likely to become hypertrophic if the wound became infected or inflamed during healing.
Important: These scars are not caused by poor wound care. They result from how your body naturally heals.
How These Scars Can Affect Comfort and Appearance
Beyond appearance, hypertrophic and keloid scars can sometimes cause physical symptoms.
Patients may notice:
These scars can also overlap with concerns related to skin texture, especially when the surface of the skin feels uneven or thickened.
How to Prevent Hypertrophic and Keloid Scars
If you know you’re prone to abnormal scarring, prevention strategies can help reduce your risk.
Pressure dressings — Applying pressure to a healing wound makes it more difficult for the scar to become elevated. This is often used after surgery in keloid-prone patients.
Silicone gel pads — These have shown promise in preventing keloids from growing and are most effective when started at the first sign of keloid formation. Daily treatment for up to 3 months is typically recommended.
Proper wound closure — If a wound needs sutures, it’s best to have it closed by a physician. Correct closure decreases the risk of hypertrophic scar formation.
Early intervention — If you notice a scar starting to become raised or firm, seeking evaluation early allows for treatment before the scar fully develops.
What to Expect During a Consultation
A consultation at Lazaderm is focused on careful evaluation and clear communication.
During your visit, your provider will:
You’ll have time to ask questions and decide whether treatment aligns with your goals.
Setting Realistic Expectations
Hypertrophic and keloid scars can often be improved, but they can be challenging to treat completely.
What to understand:
The goal is improvement in comfort, appearance, or both — not perfection.
Not all raised scars need treatment, but evaluation is important before considering any intervention. Treatment options depend on scar type, location, age of the scar, and your individual healing tendencies. A consultation helps determine the most appropriate approach.
Steroid injections are often the first-line treatment for both keloid and hypertrophic scars.
How it works: Corticosteroids are injected directly into the scar tissue to reduce inflammation, flatten the scar, and soften firmness.
Treatment protocol:
Best for:
Steroid injections can be combined with other treatments for enhanced results.
Fractional lasers can be beneficial for decreasing the height and firmness of raised scars.
How they work: Lasers create controlled micro-injuries in the scar tissue, triggering the body to remodel collagen and produce healthier, flatter tissue.
Lasers used:
Enhanced protocol for keloids: For keloid scars, applying a strong steroid (such as Clobetasol) following laser treatment can significantly improve results. This combination decreases both firmness and height of the scars.
Best for:
Microneedling offers similar benefits to fractional lasers and can be a more cost-effective option.
How it works: The Collagen PIN device creates controlled micro-channels in the scar tissue, stimulating collagen remodeling and encouraging the scar to flatten and soften.
Enhanced protocol: Similar to laser treatment, applying topical steroids after microneedling can improve results for keloid scars.
Benefits:
Ablative lasers can be used to level smaller scars with the surrounding skin.
How it works: The laser precisely removes layers of scar tissue, bringing the raised scar down to the level of surrounding skin.
Our approach: Lazaderm uses the Erbium laser for scar resurfacing because it is less traumatic to the skin. CO2 lasers induce more trauma and may actually lead to more scarring in some cases.
Best for:
Important: This approach should only be used on smaller scars due to the risk of triggering additional scarring in susceptible individuals.
For some patients, the best approach involves monitoring and maintenance rather than aggressive treatment.
When monitoring is appropriate:
Maintenance strategies:
Your provider will explain whether active treatment, monitoring, or a combination approach makes the most sense for your situation.
If you have a raised scar that feels uncomfortable or simply hasn’t healed the way you expected, a consultation can help you understand your options. At Lazaderm, consultations focus on education, safety, and thoughtful care.
