Keloids are raised, thick scars that tend to extend past the original wound. Hypertrophic scars match the area of the wound and are flat, red, and somewhat swollen. Both keloids and hypertrophic scars are an area of frustration for the people who have them as well as physicians because there is no universally accepted treatment protocol. Keloid and hypertrophic scars result from abnormal and excessive collagen buildup as a wound heals. Why this happens is unclear, although it occurs more often in darker skin tones than lighter skin tones. These scars can range from presenting an unsightly problem to actually being disfiguring. Prevention is the number one solution for keloid and hypertrophic scars. Hypertrophic scars usually resolve on their own while keloids present a difficult challenge.
Once a raised scar is present, there are a several treatments to choose from. Hypertrophic scars and keloids have been shown to respond to pressure therapy, cryotherapy (where liquid nitrogen is used to freeze off the scar), cortisone injections into the scar, topical silicone dressings, pulsed-dye laser treatment, interferon, and laser resurfacing. Simple surgical excision is usually followed by recurrence unless other topical therapies are used, such as tretinoin, AHAs, and BHA (Source: Plastic and Reconstructive Surgery, August 2002, pages 560-571). Unfortunately, even with all these options recurrence is likely, so maintenance—including gentle skin care—is essential.
An extensive, detailed list of the various treatments available can be found at www. emedicine. com, “Keloid and Hypertrophic Scar,” http://emedicine. medscape. com/ article/1057599-overview.
Scar massage is not recommended because, while it can break down the material in the skin creating the raised scar, the massage can also stimulate collagen production, which caused the scar in the first place.