Problematic Scars

Most wounds heal well in most people, but occasionally a scar may develop in a way that causes adverse cosmetic or symptomatic effects, such as stretched scars or excess skin at the ends, known as ‘dog ears’.

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Some scars can develop thicker than average, particularly in slowly-healing wounds or wounds that are very tight.  These thickened scars are called hypertrophic scars, and can be uncomfortable or itchy.  Most hypertrophic scars can be managed without surgery, and some will get better by themselves.

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Keloid scars are a rare form of abnormal scarring, and appear as firm, hard overgrowths of scar tissue, that can extend beyond the original wound margin.  They are often uncomfortable and itchy, and can be difficult to treat.  Keloid scars may occur in anyone, but are more common in those with darker skin tones, and in specific sites, such as shoulders, chest and ears.

Treatment

For simple scars, a scar revision operation may be able to correct the problem, leaving you with a fresh scar that should hopefully heal in a more acceptable manner.  For keloid scars, surgery is not usually recommended, due to the significant risk of worsening the problem scarring.  Instead, the aim of treatment is to reduce the thickness of the scar and lessen the pain and itchiness.  This can be done with regular injections into the scar every few weeks until the scar has flattened down and symptoms are gone.