Hypertrophic Scar vs. Keloid

Attribute	Hypertrophic Scar	Keloid
Definition	A raised, red, and thickened scar that remains within the boundaries of the original wound	An elevated, thickened, and irregular scar that extends beyond the boundaries of the original wound
Cause	Excessive collagen production during the healing process	Overproduction of collagen and an imbalance in collagen degradation
Appearance	Red or pink in color, raised, and may be itchy or painful	Red, purple, or dark in color, raised, and may be itchy or painful
Growth	Usually grows within the boundaries of the original wound	Can grow beyond the boundaries of the original wound
Location	Commonly occurs on areas with high tension, such as the chest, shoulders, and earlobes	Can occur anywhere on the body, but commonly found on the chest, back, shoulders, and earlobes
Treatment	Steroid injections, silicone sheets, pressure dressings, laser therapy, or surgical removal	Steroid injections, silicone sheets, pressure dressings, laser therapy, or surgical removal

Introduction

Hypertrophic scars and keloids are two types of abnormal scars that can develop after skin injuries or surgeries. While they share some similarities, they also have distinct characteristics that set them apart. Understanding the differences between hypertrophic scars and keloids is crucial for proper diagnosis and treatment. In this article, we will explore the attributes of both hypertrophic scars and keloids, highlighting their causes, appearance, growth patterns, and treatment options.

Causes

Hypertrophic scars and keloids can both occur as a result of trauma to the skin, such as burns, cuts, acne, piercings, or surgical incisions. However, the underlying causes of these two types of scars differ. Hypertrophic scars are caused by an overproduction of collagen during the wound healing process. This excess collagen leads to raised, thickened scars that remain within the boundaries of the original wound. On the other hand, keloids result from an abnormal response to wound healing, where the body produces excessive collagen that extends beyond the boundaries of the original injury, resulting in a larger, more prominent scar.

Appearance

When it comes to appearance, hypertrophic scars and keloids have some similarities, but there are also noticeable differences. Hypertrophic scars typically appear as raised, red or pink, and thickened scars. They may be itchy or painful and can sometimes regress over time. In contrast, keloids are characterized by their raised, shiny, and smooth appearance. They often have a darker color than the surrounding skin and can continue to grow indefinitely. Keloids are generally more challenging to treat due to their invasive nature and potential for recurrence.

Growth Patterns

The growth patterns of hypertrophic scars and keloids also differ. Hypertrophic scars tend to develop within the boundaries of the original wound and usually reach their maximum size within a few months. Over time, they may flatten and become less noticeable. Keloids, on the other hand, extend beyond the original wound and can continue to grow for an extended period, sometimes even years. They have a tendency to invade surrounding healthy tissue, leading to their characteristic large size and potential for recurrence after treatment.

Treatment Options

Both hypertrophic scars and keloids can be challenging to treat, but various options are available to manage their appearance and symptoms. Treatment approaches may include:

• Steroid Injections: Steroid injections are commonly used to reduce inflammation and flatten raised scars. They can be effective for both hypertrophic scars and keloids.
• Silicone Gel Sheets or Dressings: These products can help soften and flatten scars over time. They are often used as a non-invasive treatment option for hypertrophic scars and keloids.
• Cryotherapy: Cryotherapy involves freezing the scar tissue using liquid nitrogen. It can be effective in reducing the size and thickness of hypertrophic scars and keloids.
• Laser Therapy: Laser treatments, such as pulsed-dye laser or fractional laser, can help improve the appearance of both hypertrophic scars and keloids by targeting the excess collagen and promoting scar remodeling.
• Surgical Excision: Surgical removal of hypertrophic scars and keloids may be considered in certain cases. However, it is important to note that keloids have a higher risk of recurrence after surgery.

Conclusion

In conclusion, hypertrophic scars and keloids are two types of abnormal scars that can develop after skin injuries or surgeries. While they share some similarities in terms of their causes and appearance, they also have distinct attributes that differentiate them. Hypertrophic scars are characterized by raised, thickened scars that remain within the boundaries of the original wound, while keloids extend beyond the original injury and have a larger, more prominent appearance. Understanding these differences is crucial for appropriate diagnosis and treatment selection. Various treatment options are available for managing hypertrophic scars and keloids, but it is important to consider the individual characteristics of each scar and tailor the treatment approach accordingly. Consulting with a dermatologist or a plastic surgeon is recommended for proper evaluation and guidance in managing these types of scars.