Keloids and hypertrophic scars

Scars can be unsightly, and even annoying due to itching or pain, when they are exuberant, i.e. disproportionate to the wound that caused them. In these cases we are dealing with keloids and/or hypertrophic scars.

It is normal for wounds or inflammatory lesions such as acne to produce scars. However, there are certain conditions that favor the abnormal growth of these scars, with excessive and disordered accumulation of collagen, which include individual, racial predisposition, anatomical location, sustained tension in the wound, persistent inflammation due to irritants or infections, among others.

The result is then a lumpy, red scar that may be itchy or painful. Sometimes a keloid can reach a very large size, which makes it more similar to a benign tumor than a scar. This happens relatively frequently in the ear, where keloids can grow to the size of a marble or larger.

Their treatment remains a challenge, and although very satisfactory results can be achieved, it often involves a long process of treatment and control of recurrence, particularly for keloids.

Hypertrophic scars, on the other hand, respond better, faster and with little risk of relapse. Keloids are differentiated from hypertrophic scars mainly by the growth of the scar beyond the causal wound in the case of keloids.

The mainstay of treatment is the use of lasers and injected medication, such as corticosteroids and antiproliferative drugs. Surgery, cryosurgery and topical therapy also play a role in certain cases or at certain stages of treatment. Follow-up every 3-6 weeks is essential, depending on the case, to prevent and treat keloid regrowth early.

All abnormal scars are amenable to treatment. Whenever a scar is red, lumpy, painful or itchy, intervention with combinations of techniques will provide both symptom relief and cosmetic improvement.