What is a hypertrophic scar?
A hypertrophic scar is a thick, raised scar that remains confined to the area of the original injury.
It may appear:
- Red, pink, purple, brown or darker than nearby skin
- Raised and firm
- Itchy
- Tender
- Tight
- Sensitive to pressure
- Less flexible than surrounding skin
Hypertrophic scars may gradually flatten and soften over time, although improvement can take many months.
What is a keloid?
A keloid is an overgrown scar that extends beyond the boundaries of the original wound.
It may continue growing after the skin has healed and can become substantially larger than the injury that triggered it. Keloids may develop weeks, months or even years after a cut, burn, acne lesion, operation or piercing.
What is the difference between a keloid and a hypertrophic scar?
- Stays within the original wound
- Commonly appears soon after injury
- May gradually flatten
- Can remain red, thick or itchy
- Often responds more predictably to treatment
- Extends beyond the original wound
- May continue growing for months or years
- Is less likely to flatten naturally
- Has a stronger tendency to recur
- Often requires combination treatment
The distinction affects treatment choice, expected response and recurrence counselling.
What causes raised scars?
Raised scars develop when wound healing produces excess collagen and disorganised scar tissue within the deeper skin.
Potential triggers include:
- Surgery
- Burns
- Cuts
- Acne
- Chickenpox
- Vaccinations
- Ear piercing
- Tattoos
- Insect bites
- Skin infections
- Caesarean-section wounds
- Trauma
- Minor scratches in susceptible people
Keloids can occasionally follow surprisingly small injuries.
What symptoms can a keloid cause?
A keloid may cause:
- Itching
- Burning
- Tenderness
- Pain
- Tightness
- Sensitivity to clothing
- Reduced movement when close to a joint
- Emotional distress
- Difficulty wearing earrings
- Irritation from shaving
Symptoms can continue while the keloid is active and growing.
Types, options and detailed guidance
Can a hypertrophic scar turn into a keloid?
No.
They are related forms of excessive scarring but behave differently. A hypertrophic scar does not later “convert” into a keloid. A scar that continues spreading beyond the original wound may have been a keloid from the beginning or may need reassessment.
Where do keloids commonly develop?
Frequent sites include:
- Earlobes
- Chest
- Shoulders
- Upper back
- Jawline
- Neck
- Cheeks
- Upper arms
- Areas of piercing
- Surgical scars
Keloids can occur on almost any injured area, but the palms, soles and eyelids are less commonly affected.
Are keloids dangerous?
Keloids are benign and do not spread through the body like cancer.
They can still cause significant problems when they:
- Become painful
- Itch continuously
- Restrict joint movement
- Interfere with clothing
- Repeatedly become irritated
- Grow after every attempted removal
- Cause distress about appearance
A rapidly changing, ulcerated or bleeding lesion should be checked because another condition may resemble a raised scar.
Are keloids contagious?
No.
Keloids cannot spread through:
- Touching
- Towels
- Clothing
- Kissing
- Swimming
- Sexual contact
- Sharing a bed
- Living in the same household
They are an abnormal wound-healing response, not a bacterial, fungal or viral infection.
Who is more likely to develop keloids?
Risk is higher in people who:
- Have previously developed a keloid
- Have relatives with keloids
- Have South Asian, African, Caribbean, Chinese or other melanin-rich ancestry
- Are between approximately 10 and 30 years of age
- Develop acne or injuries on high-risk body sites
- Undergo piercing or elective skin procedures
- Experience prolonged wound inflammation
Keloids can occur in any skin tone, but they are more frequent and often more noticeable in brown and black skin.
How do keloids appear on Indian skin?
On Indian skin, a keloid may appear:
- Skin-coloured
- Pink-brown
- Red-brown
- Purple
- Dark brown
- Shinier than nearby skin
- Surrounded by pigmentation
Treatment can also produce dark or pale marks. Corticosteroid injections may occasionally cause lighter skin, while cryotherapy carries a meaningful risk of lasting pale pigmentation in darker skin tones.
Do keloids run in families?
They can.
A family history suggests inherited susceptibility to excessive scar formation. Patients should tell surgeons, dentists, dermatologists and piercing professionals when they or a close relative have developed keloids.
This information can influence wound closure, scar prevention and whether an elective procedure should be avoided.
Can acne cause keloids?
Yes.
Deep inflammatory acne can lead to:
- Hypertrophic scars
- Papular raised scars
- Keloids
- Dark post-inflammatory marks
- Depressed scars occurring alongside raised scars
Raised acne scars require a different approach from indented acne scars. Early treatment of active acne can reduce the likelihood of additional scarring.
Can ear piercing cause keloids?
Yes.
Earlobe and cartilage piercings are common triggers in susceptible patients. Early signs may include:
- Thickening around the piercing
- Increasing firmness
- Itching
- A bump that continues enlarging
- Extension beyond the original piercing hole
Early assessment may allow pressure treatment or injections to be considered before the lesion becomes large.
Should someone with a keloid get another piercing or tattoo?
Usually, extra caution is advisable.
A person who has already formed a keloid has a higher risk of developing another after:
- Piercing
- Tattooing
- Cosmetic surgery
- Elective skin procedures
- Unnecessary mole removal
- Permanent makeup
Avoiding non-essential skin injury is the most reliable form of prevention for strongly keloid-prone patients.
Additional care and practical advice
Can a caesarean-section scar become raised?
Yes.
A C-section scar may become hypertrophic or, less commonly, develop keloidal overgrowth.
Assessment considers:
- Whether the scar extends beyond the incision
- Pain or itching
- Width and thickness
- Previous infection
- Tension across the wound
- Pregnancy or breastfeeding status
- Future pregnancy plans
Treatment may include silicone, injections or another scar-directed approach after the wound has completely healed.
Can burns cause hypertrophic scars?
Yes.
Burn injuries are a common cause of hypertrophic scarring, particularly when healing is prolonged or the wound extends deeply into the skin.
Burn scars can also cause:
- Tightness
- Reduced movement
- Contractures
- Itching
- Pain
- Pigment changes
Scars limiting a joint or causing a contracture may require coordinated dermatology, plastic-surgery, physiotherapy or burn-specialist care.
Can keloids develop without an obvious injury?
Occasionally, the triggering injury may have been so minor that the patient does not remember it.
Possible unnoticed triggers include:
- Small acne lesions
- Insect bites
- Folliculitis
- Minor scratches
- Shaving injury
- A small vaccination site
- A previously inflamed hair follicle
A lesion with no convincing injury history may require closer examination or biopsy to confirm that it is truly a keloid.
Keloid and hypertrophic-scar differentiation
The scar is assessed to determine whether it stays within or extends beyond the original wound.
Symptoms assessed alongside appearance
Pain, itching, tightness and restricted movement are included in treatment planning.
Indian-skin considerations
The risk of darkening, lightening and treatment-related pigmentation is considered before injections, cryotherapy or laser.
Biopsy when needed
Skin biopsy is available at both branches for atypical or uncertain raised lesions.
Appropriate referral
Large, recurrent or surgically complex keloids may be referred for plastic-surgical or radiation-oncology care.
Realistic expectations
The clinic does not promise complete, scar-free or permanent removal.
General dermatology, fractional CO₂ laser, MNRF and skin biopsy are confirmed at both locations. Keloid injections, cryotherapy, excision and other scar-specific procedures should be confirmed after consultation.
Additional cost depends on:
- Whether the scar is hypertrophic or keloidal
- Scar size and thickness
- Number of scars
- Body area
- Silicone treatment
- Injection medicine
- Number of injection sessions
- Laser or another procedure
- Biopsy in an uncertain case
- Surgical referral
- Pressure earrings or garments
- Follow-up after the included 10-day period
An exact quote requires examination because a small earlobe scar requires different care from a large recurrent chest or post-burn keloid.
How care is planned
- Assessment comes before treatment selection.
- Options, limitations, aftercare and expected timelines are explained.
- The plan is adapted to diagnosis, skin type and medical history.
Choose a clinic in Jammu
Karan Nagar
Lane 2, Karan Nagar, near Amphalla Chowk, Jammu – 180005Doctor consultation:
Mon–Sat 11:00 AM–4:00 PM
Sun 11:00 AM–3:00 PM
Paloura Chowk
Top Paloura, opposite Government Senior Secondary School, Jammu – 181121Doctor consultation:
Mon–Sat 6:00 PM–8:00 PM
Sun 10:30 AM–12:00 PM
Frequently asked questions
Is every raised scar a keloid?
No.
Possible alternatives include:
- Hypertrophic scar
- Dermatofibroma
- Cyst
- Foreign-body reaction
- Infected piercing
- Allergic reaction to jewellery
- Sarcoidosis
- Benign skin growth
- Rarely, a skin tumour
A contact reaction to jewellery can occasionally mimic swelling around an ear piercing. Biopsy may be used when the diagnosis remains uncertain.
How does Dr. Cheena Langer assess a raised scar?
A consultation may include:
- Reviewing the original injury
- Examining whether growth extends beyond the wound
- Measuring scar height and surface area
- Assessing colour, firmness and flexibility
- Asking about pain, itch and burning
- Checking whether movement is restricted
- Reviewing earlier injections or surgery
- Asking about family history
- Checking for active acne or infection
- Assessing skin tone and pigmentation risk
- Considering clinical photographs with consent
- Considering biopsy when the diagnosis is uncertain
A dermatologist can usually diagnose a keloid clinically.
When is a biopsy required?
Biopsy may be considered when:
- The diagnosis is uncertain
- The lesion is unusually hard or irregular
- It grows rapidly
- It bleeds or ulcerates
- It appears without a clear injury
- Treatment repeatedly fails
- Another inflammatory condition or tumour is possible
Skin biopsy is confirmed as available at both Aastha Skin Centre branches when clinically required.
Do keloids disappear naturally?
Keloids usually do not disappear without treatment.
They may eventually stop growing and become less symptomatic, but the raised tissue generally remains. Hypertrophic scars have a greater tendency to flatten and soften over time.
Can keloids be permanently cured?
No treatment can guarantee permanent cure.
Treatment may:
- Flatten the scar
- Soften it
- Reduce redness or darkness
- Relieve pain and itching
- Improve movement
- Make it less noticeable
- Reduce further growth
Recurrence remains possible, especially after surgical removal. Combination treatment is often used because keloids respond unpredictably.
Does every raised scar need treatment?
No.
Observation may be reasonable when the scar:
- Is small and stable
- Causes no pain or itch
- Does not restrict movement
- Does not bother the patient
- Has a clear benign diagnosis
Earlier treatment may be considered when a scar is actively thickening, painful, itchy or extending beyond the original wound.
How are keloids and hypertrophic scars treated?
A treatment plan may include:
- Silicone gel or silicone sheets
- Pressure therapy
- Corticosteroid injections
- Another intralesional medicine
- Cryotherapy
- Laser or light treatment
- Surgical removal with recurrence prevention
- Specialist post-operative radiation in selected cases
- Combination treatment
No single option is ideal for every scar. Size, site, symptoms, skin tone and previous treatment determine the plan.
Get a clear plan for keloid & hypertrophic scar
Request a consultation with Dr. Cheena Langer at Karan Nagar or Paloura Chowk.
Medical disclaimer: Results may vary from person to person. This content is for informational purposes only and does not substitute a consultation with a qualified medical professional. Dr. Cheena Langer, MD is a registered medical practitioner.