Keloid and Hypertrophic Scar

What it is

Keloids and hypertrophic scars are exaggerated skin responses to healing, with excessive collagen production. A hypertrophic scar is raised and reddened, but stays within the boundaries of the original wound and tends to improve over time. A keloid grows beyond the wound, can keep growing for years, causes itching and pain, and is more common in brown and Black skin, on the chest, shoulders, earlobes, and after C-sections and other surgeries. At Femi Saúde, the general surgery team, with Dr. Henrique Stachon, evaluates each scar and combines injections, laser, silicone sheets, and, in selected cases, surgery, always with measures to reduce the chance of recurrence.

Most common symptoms

• Raised, firm and shiny scar
• Growth beyond the original wound
• Itching and tenderness in the scar
• Pain or burning to the touch
• Redder or darker color than the surrounding skin
• Restricted movement when located over joints

Causes and risk factors

• Surgeries, C-sections and cuts
• Acne, piercings and burns
• Genetic and family predisposition
• More pigmented skin
• Excessive tension on the wound
• Prolonged wound infection or inflammation

How it is diagnosed

Diagnosis is clinical: the surgeon examines the scar, its relationship to the boundaries of the original wound, how long it has been developing, its color, consistency, and the presence of symptoms such as itching and pain. Personal and family history of abnormal scarring and skin type help estimate the risk of new keloids. Standardized photographs document the response to treatment across sessions. In atypical lesions or unusual growth, a biopsy may be indicated to rule out other diagnoses.

How we treat it at Femi Saúde

Treatment is stepwise and almost always combined. Corticosteroid injections into the scar reduce its size, itching and pain; silicone sheets, gels and compression help control growth. Laser improves color, texture and thickness. For this reason, the general surgery team at Femi Saúde reserves surgical removal for large or unresponsive keloids, always combined with injections or other measures after surgery, since removal alone has a high recurrence rate. Recent hypertrophic scars usually respond well to silicone, massage and sun protection.

What we offer