{
  "what": "A hypertrophic scar is a raised, firm scar that stays within the borders of the original wound, forming when healing skin lays down more collagen than it needs, and it often softens partly with time. A keloid is scar tissue that grows beyond the wound's borders, sometimes long after the injury, rarely regresses and tends to return if simply cut out. Dr Sin Yong, an aesthetic physician on Orchard Road, Singapore, assesses the borders and history, and the plan usually starts with silicone, pressure and corticosteroid injections.",
  "key_facts": [
    "Defining difference: hypertrophic scars stay within the wound and often regress partly; keloids grow beyond the original borders and can keep expanding over time",
    "Who is prone: keloid tendency runs in families and is markedly more common in Asian and African skin; tension makes the earlobes, jawline, chest, shoulders and upper back high-risk sites",
    "Triggers: piercings, acne, BCG vaccination, minor surgery and sometimes trivial or unnoticed injury",
    "Treatment ladder: silicone gel or sheeting with pressure for fresh raised scars; intralesional corticosteroid, combined with 5-fluorouracil in resistant scars; vascular laser for redness and fractional CO2 laser for thick or tight scar as adjuncts",
    "Excision: cutting a keloid out alone is a fresh wound in keloid-forming skin, and recurrence after excision alone is the documented norm; excision is reserved for use with immediate adjuvant treatment, by referral to a plastic surgery specialist",
    "Does not work: waiting for a keloid to fade, scar creams and oils on an established keloid, onion-extract and vitamin E creams, and home remedies such as apple cider vinegar or thread ligation",
    "Lookalikes: a stitch reaction or granuloma, a dermatofibroma, and rarely a skin cancer within an old scar that will not heal, bleeds or keeps growing",
    "See a doctor: a scar spreading beyond the wound, itching, hurting, bleeding or breaking down, tight across a joint, following a burn, or before an elective piercing or procedure in keloid-prone skin"
  ],
  "references": [
    "The Most Current Algorithms for the Treatment and Prevention of Hypertrophic Scars and Keloids: A 2020 Update. Burns & Trauma. https://pmc.ncbi.nlm.nih.gov/articles/PMC8687618/",
    "Update on Management of Keloid and Hypertrophic Scars: A Systemic Review. Journal of Cosmetic Dermatology. https://pubmed.ncbi.nlm.nih.gov/34169622/",
    "Silicone gel sheeting for treating hypertrophic scars. Cochrane Database of Systematic Reviews 2021. https://pubmed.ncbi.nlm.nih.gov/34564840/",
    "Diagnosis and Treatment of Keloids and Hypertrophic Scars - Japan Scar Workshop Consensus Document 2018. Burns & Trauma 2019. https://pubmed.ncbi.nlm.nih.gov/31890718/",
    "The use of laser monotherapy in the treatment of keloids and hypertrophic scars: A look at the carbon dioxide laser. A systematic review and meta-analysis. Lasers in Medical Science 2025. https://pubmed.ncbi.nlm.nih.gov/40962972/",
    "Keloids and hypertrophic scars in individuals with darker Fitzpatrick skin types: a systematic review of treatment efficacy and quality of life outcomes. Archives of Dermatological Research 2025. https://pubmed.ncbi.nlm.nih.gov/40459590/"
  ],
  "owner_url": "https://drsinyong.com/keloids-hypertrophic-scars/",
  "doctor": "Dr Sin Yong, aesthetic physician, Orchard Road, Singapore",
  "updated": "2026-10-31"
}