Keloid vs. Hypertrophic Scar: What’s the Difference?

Dr. Parvin Shafa | July 17, 2026

Keloids and hypertrophic scars are both raised scars that develop after the skin heals from an injury. While they may appear similar, they behave differently and often require different treatment approaches. Understanding the difference is important because early diagnosis can help improve treatment outcomes and prevent unnecessary scar growth.

At OC MedDerm in Irvine, CA, Dr. Parvin Shafa evaluates raised scars and develops personalized treatment plans based on the type of scar, its location, and your individual skin.

What Is a Keloid?

A keloid is an overgrowth of scar tissue that extends beyond the boundaries of the original wound. Unlike normal scars, keloids continue growing even after the skin has healed.

Keloids may develop after:

• Ear piercings
• Acne
• Surgery
• Burns
• Cuts
• Tattoos
• Vaccinations

They can become itchy, painful, tender, or cosmetically bothersome.

What Is a Hypertrophic Scar?

A hypertrophic scar is a raised scar that develops during the normal healing process. Unlike a keloid, it remains confined to the original wound and often improves over time.

Hypertrophic scars commonly occur after:

• Surgical incisions
• Burns
• Cuts
• Traumatic injuries

Many gradually flatten over several months without becoming larger.

Keloid vs. Hypertrophic Scar: Key Differences

Feature	Keloid	Hypertrophic Scar
Growth	Extends beyond the original wound	Stays within the original wound
Appearance	Thick, firm, raised	Raised but confined
Progression	Continues to grow	Usually stabilizes and gradually flattens
Symptoms	May itch, hurt, or feel tender	May be mildly itchy or uncomfortable
Common Locations	Ears, chest, shoulders, jawline	Anywhere skin has been injured
Recurrence	Higher risk after treatment	Lower recurrence risk

What Causes These Scars?

Both scar types develop when the body produces excess collagen during healing.

However:

• Keloids result from excessive collagen production that continues beyond normal healing.
• Hypertrophic scars produce excess collagen only during the healing phase and usually improve with time.

Genetics also play an important role. People with a personal or family history of keloids have a greater risk of developing them.

How Can You Tell the Difference?

You may have a keloid if your scar:

• Continues to grow
• Extends beyond the original injury
• Appears months after healing
• Feels itchy, painful, or tender

You may have a hypertrophic scar if it:

• Stays within the original wound
• Appears soon after healing
• Gradually becomes flatter over time

A dermatologist can often distinguish between the two through a clinical examination. In some cases, additional evaluation may be recommended.

How Are Keloids Treated?

Treatment depends on the size, location, and severity of the keloid.

Options may include:

• Steroid injections
• Cryotherapy
• Laser therapy
• Silicone therapy
• Surgical removal in selected cases
• Combination therapy to reduce recurrence

Because keloids often return, combination treatment usually provides the best results.

How Are Hypertrophic Scars Treated?

Many hypertrophic scars improve naturally over time.

When treatment is needed, options may include:

• Silicone gel or sheets
• Steroid injections
• Laser treatments
• Scar revision
• Microneedling in selected cases

Treatment is individualized based on the scar’s appearance and symptoms.

Can You Prevent Raised Scars?

While not all raised scars can be prevented, you can reduce your risk by:

• Following proper wound care instructions
• Treating acne early to prevent deep inflammation
• Avoiding unnecessary skin trauma if you’re prone to keloids
• Protecting healing skin from sun exposure
• Seeking early treatment if a scar continues to grow

When Should You See a Dermatologist?

Schedule an evaluation if you have:

• A scar that continues growing
• A raised scar that is painful or itchy
• A scar extending beyond the original wound
• A history of keloids
• Cosmetic concerns about a raised scar

Early evaluation may help prevent further scar enlargement and improve treatment outcomes.

Keloid Treatment in Irvine, CA

Whether you have a keloid or a hypertrophic scar, an accurate diagnosis is the first step toward effective treatment.

At OC MedDerm, Dr. Parvin Shafa provides personalized treatment plans for raised scars using advanced therapies tailored to each patient’s needs. If you’re concerned about a scar that continues to grow or causes discomfort, schedule a consultation to discuss your treatment options.

Frequently Asked Questions (FAQs)

Can a hypertrophic scar turn into a keloid?

No. Although they may look similar, hypertrophic scars and keloids are different types of scars with distinct healing patterns.

Do keloids go away on their own?

No. Keloids typically do not shrink without treatment and may continue to grow over time.

Are keloids dangerous?

Keloids are usually benign but can cause itching, pain, tenderness, and cosmetic concerns.

Which scar is more likely to come back after treatment?

Keloids have a higher risk of recurrence than hypertrophic scars, which is why combination therapy is often recommended.

How do dermatologists diagnose a keloid?

Diagnosis is usually based on your medical history and a physical examination. In some cases, a biopsy may be recommended if the diagnosis is uncertain.

Can raised scars be treated without surgery?

Yes. Many raised scars improve with non-surgical treatments such as steroid injections, cryotherapy, laser therapy, or silicone therapy.