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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Can ear piercing caused keloids be cured?

After getting ear piercings, some patients may develop keloids, which could be related to individual body reactions. Some cases are due to a person's scar constitution. First, the size of the keloid should be examined. If the keloid is small and does not show obvious growth, it is generally considered appropriate to observe and regularly re-examine the growth. However, if the keloid is large and gradually increasing in size, surgical removal should be considered. After surgery, superficial radiotherapy is recommended to help prevent recurrence. However, it is typically necessary to have regular follow-ups post-surgery, as some patients are prone to recurrence.

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Can keloids be cured?

Once keloids appear, they are essentially irreversible, meaning that they cannot be completely cured clinically. The formation of keloids is mostly related to one's own constitution, such as a keloid-prone skin type. Some keloids are also due to trauma occurring in areas of the skin where muscular tension is relatively high, or where the wound is indeed large and deep, which might lead to the formation of keloids. In such cases, localized drug injections can be used to reduce and soften the keloids. One can also use ointments that soften scars, such as keloid soothing and softening cream, but these require long-term application to be effective. If the keloid is relatively small, cosmetic surgery to remove and re-sew the area can also be an option for treatment. In summary, once keloids have developed, they are not easy to completely cure.

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What does "scar constitution" mean?

Scar constitution is a type of special genetic constitution, typically leading to larger scars from minor injuries, especially in areas such as the chest and back where skin and muscles are tense. People with scar constitution should avoid injuries or bumps, particularly avoiding scratching or squeezing folliculitis on the chest, as scars formed are difficult to completely remove. Common anti-scar medications often do not work well. If scar proliferation is significant, treatment with medical injections in a standardized hospital's dermatology department may be required. Regular exercise, boosting the immune system, avoiding spicy or irritating food, and avoiding staying up late can help reduce the frequency of this condition.

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What should not be eaten with hypertrophic scars?

Hypertrophic scars, in themselves, result from constitutional issues, meaning they are tied to an individual's physical condition and have certain hereditary elements. This condition significantly affects appearance, and certain dietary items can further irritate hypertrophic scars. Thus, it is recommended to avoid certain stimulating foods such as bamboo shoots, beef, crucian carp, and seafood, as these can impede the healing of hypertrophic scars. Moreover, if symptoms are pronounced, or if irritation is prominent, it is also advisable to avoid spicy foods, alcohol, and smoking. Such irritants can notably aggravate the skin, potentially leading to localized scar sensitivity.

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What will happen if hypertrophic scars are not treated?

Hypertrophic scars are actually related to individual constitution. This condition mainly occurs due to scarring following an injury, which leads to excessive growth of scar tissue. As long as there are no inflammatory changes, generally, hypertrophic scars do not cause any problems. However, some hypertrophic scars may develop into malignant lesions, particularly in areas that are easily stimulated, such as the soles of the feet or the armpits. If a hypertrophic scar persists and the area is continually stimulated, it may lead to changes in the scar, which, in severe cases, could even become malignant. In such situations, it is crucial to manage the condition promptly based on the specific circumstances. Safe treatment measures usually involve techniques such as laser surgery.