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Keloid vs Hypertrophic Scar: How Treatment Differs and Why It Matters
Keloids and hypertrophic scars look similar but require different treatments. Dermatologists explain how to tell them apart and why using the wrong treatment can make keloids worse.
Keloid vs Hypertrophic Scar: Treatment Differences
Both keloids and hypertrophic scars are raised, thick scars that form after skin injury — but they are biologically different conditions that respond differently to treatment.
Key Differences
Keloids extend beyond the original wound boundary, rarely regress spontaneously, and have a high recurrence rate after removal. Hypertrophic scars stay within the wound boundary and often improve on their own within 1-2 years.
Why Misidentification Matters
Treating a keloid like a hypertrophic scar — for example, by surgically excising it without adjuvant therapy — often makes the keloid larger. Surgery alone has a keloid recurrence rate of up to 100% without additional treatment.
Treatment for Hypertrophic Scars
- Silicone gel sheets (first-line)
- Massage therapy
- Pulsed dye laser
- Corticosteroid injections for persistent cases
Treatment for Keloids
- Corticosteroid injections (triamcinolone) — most common first-line
- Cryotherapy combined with steroids
- Radiation therapy post-excision (for recurrent keloids)
- Laser therapy (585nm pulsed dye laser)
- Surgery only when combined with radiation or steroid injections
Medical Disclaimer
This content is for educational purposes only. Consult a dermatologist for diagnosis and treatment of any scar condition.
Tags
keloidhypertrophic scarscar treatmentdermatologyskin healing
Primary Source
American Academy of Dermatology (AAD)Medical Disclaimer: This article is for educational and informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of your physician or other qualified health provider with any questions you may have regarding a medical condition.
About the Author
Dr. Lisa Thompson
AI Dermatologist
Dr. Lisa Thompson is HF Health AI's dermatology educator and one of the platform's most-read specialists, with over 150 published articles on skin health, common skin conditions, sun protection, wound healing, and evidence-based skincare. Her content is developed in strict alignment with guidelines from the American Academy of Dermatology (AAD) and references peer-reviewed research from the Journal of the American Academy of Dermatology (JAAD) and the British Journal of Dermatology. Dr. Thompson is the platform's primary authority on keloid scars, contact dermatitis, eczema, psoriasis, and rosacea.
Sources & References
This article draws on information from the following authoritative health organizations. Always consult a qualified healthcare professional for personal medical advice.