Differences between hypertrophic scar and keloid

Hypertrophic and keloid scars are pathologies or disorders of the dermis that occur in humans after surgery, burns, inflammation or any type of trauma to the skin. Both scars are species of fibrous and proliferative lesions that form at the edges of a wound.

Many people are prone to developing this type of scar while others do not. In this sense, both are unsightly forms that generate a bulging of the wound and that can be reduced with certain treatments but in general they do not disappear completely. Therefore, it is of our interest to present the differences between hypertrophic and keloid scars, based on their definitions for the consideration of the readers.

hypertrophic scar

The hypertrophic scar is a raised, erythematous, fibrous lesion that forms within the initial edges of a wound, usually in an area of ​​skin tension. Additionally, this type of scar is usually pruritic, that is, it causes the person to itch and usually has a pattern of regression or spontaneous reduction, in addition, it has little tendency to reappear after surgical removal.

This type of scar is raised, red and rough, remaining within the edges of the initial wound, without exceeding them. Its size is related to the size of the wound and it appears early after the injury, and may worsen in the following 6 months. Its maturation phase can last up to 2 years and in most cases it could improve without any treatment, while in some cases, corrective surgery is necessary to eliminate said lump.

It should be noted that some people may have a genetic predisposition to develop a hypertrophic scar, in addition, some predisposing factors may be young age and blood type A. Finally, among the most frequent areas of appearance of these injuries are the surfaces of greatest flexion such as joints and abdomen.

Keloid scar

The keloid scar is a tumor-like, pinkish-red or purple, sometimes hyperpigmented lesion that appears after surgery. The contours of this scar are usually well demarcated, but are irregular, extending beyond the initial margins of the wound and extending to areas close to the wound.

The keloid may have focal areas of ulceration and may be itchy and painful. Thus, once the keloid scar is present, it is very likely that it must be removed with surgery, since it does not tend to disappear spontaneously. Patients who develop this type of lesion must be in constant medical follow-up, since its reappearance after surgical removal is very frequent.

On the other hand, keloid scars are not directly related to skin tension but to the type of tissue where the wound occurred, therefore, the most frequent areas where these injuries usually appear are the areas of fibrous tissue such as ears, shoulders, region pre-sternal, back and thorax.

According to the above, the differences between these two scars are:

hypertrophic scar Keloid scar
They are more frequent in flexion and tension surfaces such as joints and abdomen. They are more frequent on the surface of fibrous tissue such as the chest, shoulders and back.
It appears early after surgery. It can appear months after surgery.
The size is related to the wound, since its limits are within it. The size is not related to the wound, since its limits usually exceed it
It does not reappear after removal surgery. It may appear after removal surgery.

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