Can hypertrophic and keloid scars be completely removed?

Scars, whether hypertrophic or keloid, are a permanent part of the skin that forms after wounds heal. These scars form when the body repairs itself following an injury such as cuts, burns, or even after surgery or certain skin conditions like acne [1]. Although scars typically fade over time, they do not disappear completely. The goal of available treatments is to reduce their appearance and improve their texture and overall look, rather than removing them entirely.

Understanding Hypertrophic and Keloid Scars

Hypertrophic and keloid scars are types of raised scars that form as a result of an overgrowth of fibrous tissue during the healing process. Hypertrophic scars are characterized by remaining within the boundaries of the original wound, whereas keloid scars extend beyond the boundaries of the original wound and may be larger and more prominent [1]. The appearance of a scar depends on several factors, including the size and depth of the wound, its location, the time it takes to heal, the person's age, and their genetic predisposition to forming scars [1].

Available Treatment Options for Reducing Scars

There is a variety of treatments that can help reduce the appearance of scars and improve how they look. These treatments do not remove scars completely, but they aim to make them less noticeable and smoother. Among the most prominent options are:

• Scar Revision: This procedure involves removing the old scar and re-stitching the skin in a way that minimizes the visibility of the new scar [1].
• Chemical Peels: These can be used to improve the texture and color of the scar by removing the top layers of the skin [1].
• Dermabrasion: This involves removing the top layers of the skin using a special device to resurface the area, which helps in smoothing the scar and improving its appearance [2].
• Laser Resurfacing: Various laser techniques are used to resurface the skin, reduce redness, and improve texture [1].
• Injections: Certain substances, such as corticosteroids, can be injected directly into the scar to reduce its size and flatten it, especially in cases of hypertrophic and keloid scars [1].
• Creams and Ointments: Some topical creams and ointments may help reduce the appearance of scars, especially if used early on [1].

Next Steps and Important Considerations

When considering scar treatment, it is essential to consult a dermatologist or plastic surgeon. The physician will evaluate the type of scar, its location, its size, as well as your overall health to determine the best treatment plan for you. Multiple treatment sessions may be required, and results may vary from person to person. It is important to have realistic expectations regarding the results, as the goal is improvement rather than complete removal [1].

After any treatment procedure, it is essential to follow the doctor's instructions carefully to ensure optimal healing and minimize the risk of complications. For example, after dermabrasion, the skin may be red and swollen for 2 to 3 weeks, and it must be protected from the sun for 6 to 12 weeks [2]. If you notice that the skin remains abnormally red and swollen after healing has begun, this may be a sign of abnormal scar formation, and you should inform your doctor immediately [2]. You can read more about the available treatment options for hypertrophic and keloid scars at Treatment of Hypertrophic and Keloid Scars (Arabic).

Medical references

• Scars
• Dermabrasion