The difference between hypertrophic scars and keloids

Written by Tang Da Wei
General Surgery
Updated on September 13, 2024
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In a strict sense, hypertrophic scars and keloids are similar in their pathogenesis. For hypertrophic scars, the typical presentation is localized overgrowth at the scar site, which means that there is an overgrowth during the wound healing process, resulting in a relatively large and numerous scar. Keloids represent a more severe condition where there is a localized raised scar on the wound, which can be significantly large, sometimes resembling a bug on the surface of the scar. They are more likely to occur in areas like the neck, behind the ears, and under the earlobes. For the treatment of hypertrophic scars and keloids, if the patient has a predisposition to scarring, considerations include early intervention during wound suturing and healing, such as injection of medications or radiation therapy.

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Written by Liu Gang
Dermatology
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How to remove keloids?

The formation of keloids is largely related to one's inherent scarring constitution. Some patients are not prone to keloids but can still develop them due to particularly deep or large wounds. Additionally, keloids can form on the chest or shoulders after repeated occurrences of folliculitis. Currently, there are not many treatments for keloids. For larger keloids, medication can be used locally to gradually soften and reduce their size. For smaller areas, cosmetic surgical methods can be employed for removal, although this does not guarantee prevention of recurrence. Once keloids appear, they are mostly irreversible. If the keloid grows rapidly, treatment can also be sought at nuclear medicine departments, where nuclear radiation therapy is used.

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Written by Zhang Da Wei
General Surgery
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What should I do if I have pain from hypertrophic scars?

Once an injury occurs, it is very likely to develop hypertrophic scars, and the appearance of such scars is related to the individual's constitution, often accompanied by symptoms such as pain. When this condition occurs, specific treatments are definitely needed for improvement, typically using laser surgery as the main treatment, or it can be removed at once through surgical operation, which helps improve the condition. Of course, hypertrophic scars can also be improved through some physical therapy methods, such as by adjusting in different degrees, like acupuncture, which can fade the scars by improving local blood circulation. However, physical therapy is just one aspect; consistent improvement in lifestyle habits to avoid recurrent stimulation of hypertrophic scars is also crucial for recovery.

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Written by Tang Da Wei
General Surgery
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How to eliminate hypertrophic scars?

For the elimination of hypertrophic scars, one can apply anti-scarring ointment to the surface early after surgery. If the patient indeed has a scarring constitution, at the end of the surgery, it is advisable to inject medications into the subcutaneous area or within the wound tissue to prevent excessive or abnormal scar proliferation. If necessary, radiotherapy can be applied; under the effect of X-rays, it can effectively prevent the abnormal proliferation of scar tissue and the abnormal and excessive growth of fibroblasts. If there is already hypertrophic scarring, one might consider excising the hypertrophied scar tissue and re-suturing the wound.

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Written by Zhang Da Wei
General Surgery
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What should I do about hypertrophic scars?

Hypertrophic scar keloids are actually quite common in everyday life. Generally, this type of scarring can be divided into three stages: the proliferative phase, the stable phase, and the recovery phase. If care is not taken, the likelihood of developing such keloids increases. Moreover, the occurrence of hypertrophic scar keloids also relates to an individual's constitution. For instance, those with a scar-prone constitution are more likely to encounter this issue. When such issues arise, it is advisable to use some reparative ointments appropriately to help improve the condition. Additionally, combining massage techniques or localized stimulation methods can also assist in improvement, enabling better recovery. Over time, the scars should gradually fade. Of course, in such cases, methods like laser surgery or dermabrasion can also be used to help eliminate these scar-like keloids, potentially speeding up the recovery. (Please follow a doctor’s guidance for specific medication usage and avoid self-medicating.)

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Written by Zhang Da Wei
General Surgery
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Can hypertrophic scars be effectively treated?

Hypertrophic scars are related to constitutional issues, generally directly associated with congenital genetic factors. Thus, while it is possible to improve the condition of hypertrophic scars, it is impossible to completely remove them, as altering such constitutional issues entirely is very challenging. When dealing with hypertrophic scars, one can choose various methods to alleviate the condition, such as improving local tissue vitality through massage, which can promote skin regeneration and thus mitigate the effects of hypertrophic scars. Additionally, treatments for hypertrophic scars can include laser surgery or the use of medications that invigorate blood circulation and disperse blood stasis. Importantly, preventing wounds and thus avoiding scar formation is crucial for optimal prevention. (Use medication under the guidance of a doctor, and do not self-medicate).