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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What should I do about auricular keloids?

Auricular keloids are a relatively common clinical condition, which may be related to an individual's scar constitution. Firstly, it is necessary to examine the size of the keloid. If the keloid is small, without obvious enlarging, redness, pain, infection, or inflammation, this situation generally can be considered for observation followed by regular ENT (ear, nose, and throat) specialist follow-ups to check for any rapid growth. However, if the keloid is large and progressively growing, surgical removal should be considered. After the surgery, local superficial radiation therapy can be considered to help prevent postoperative recurrence.

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What should I do if a keloid is itchy?

Keloids can be very itchy when at home. You can use some cryotherapy such as applying ice for treatment. However, if the results are unsatisfactory, it might be necessary to visit a hospital for a comprehensive treatment, including medication. Treatment based on the condition can control these symptoms. The itching occurs because the skin's metabolic system is damaged, causing metabolic products to accumulate in the scar.

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How to repair hypertrophic scars?

In cases of trauma or injury, it is very easy to develop hypertrophic scars. Generally, the size and depth of the wound are related factors. Scars often present with symptoms like redness, itching, and raised hard areas. There are mainly two approaches to treat this type of scar. The first method involves improvement through medications, using topical drugs or local injections to help eliminate hypertrophic scars. The second method involves surgical approaches, such as laser surgery, which is a common method of repair. Generally, local burning from the procedure can achieve certain effects. Of course, after using laser surgery, a specific recovery period is required. During this period, it is necessary to avoid infections to aid in the repair of hypertrophic scars.

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Written by Liu Gang
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Treatment of keloids

The formation of keloids is somewhat related to an individual's scar constitution. Once keloids have formed, there is a lack of a perfectly effective treatment plan. The most commonly used treatments are topical ointments, which can't completely solve the problem. The most frequent treatment involves local application of steroid medications, which can be chosen based on the size of the keloid to be treated 2-3 times, or even four to five times. After treatment, the keloids will gradually shrink, become softer, and smaller, but they will not completely disappear. If the keloid proliferation is not particularly severe, one can also visit a dermatology department at a formal hospital to use fractional laser treatment. Currently, there are many other drug treatments available, but their ultimate effects are not certain, so it is best to prevent such conditions in individuals prone to keloids, avoiding external injuries or scars.

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What are hypertrophic scars like?

Hypertrophic scars are actually directly related to a scar-prone constitution, and generally, when such scars occur, they are divided into several types. The first type is caused by regressive changes, and the outcomes in this situation are generally quite ideal. However, improvement in these cases usually needs to be tailored to the specific circumstances. If the issue with hypertrophic scars is more pronounced, it can be addressed with laser surgery to achieve effective treatment. Of course, it requires specific analysis; not every issue in this regard necessitates intervention, but it should be addressed promptly. Moreover, if a scar-prone constitution persists, it might have some direct impacts. Decisions on improvement can be made based on the specific size of the scar area.