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Keloids and hypertrophic scars represents two forms of abnormal wound healing.  They differ in their extent.  Keloids tend to extend beyond the original site of injury, often with "claw-like" extensions resembling the pincers of a crab, while hypertrophic scars are usually less elevated and their size remains confined to the size of the original injury.   

Keloids and hypertrophic scars can occur anywhere, but are most common on the chest, back and shoulders.  Individual lesions are sometimes itchy or uncomfortable.  They are benign growths and are not dangerous.

Who gets Keloids and Hypertrophic Scars?

Keloids are more common in younger individuals, and in those of African or Asian ancestry, but can occur in people of all ages and backgrounds.   

What Causes Keloids and Hypertrophic Scars?

The exact cause of this abnormal scarring is unknown.  It tends to run in families and there may be a genetic component.

How are Keloids and Hypertrophic Scars Treated?

  • Small hypertrophic scars can sometimes be treated with silicone gel or silicone gel sheeting that is available over-the-counter
  • Most keloids and hypertrophic scars are treated with injections of a cortisone medication.  This flattens the scars.  Several treatments are often needed.   This treatment is often effective but improvements may not be permanent; further treatments may be needed months or years later
  • Very large keloids or those that have not responded to cortisone injections are sometimes treated with surgical excision combined with injections

Can Keloids or Hypertrophic Scars be Prevented?

If you are at risk for the development of such scars (if you have had them before), consider the following suggestions:

  1. Avoid all non-essential surgical procedures
  2. Acne is a frequent cause of keloids an hypertrophic scars.  If you have acne and are prone to such scars be sure to treat your acne to decrease the risk of scar development
  3. Consider applying silicone gel sheeting preventatively to wounds or surgical sites