Keloids and Hypertrophic Scars: A Review of Risk Factors, Pathophysiology, Prevention, Management, and Treatments in Dermatology and Surgical Practice

Abstract

Introduction: Hypertrophic scars and keloids are the results of a fibroproliferative disorder involving an aberrant wound healing response to dermal injuries that lead to the development of these benign lesions. Careful consideration of the patient populations that are most prone to developing keloids and hypertrophic scars has revealed that genetics may play a role in developing these pathological scars. The clinical distinction between these two lesions has classically relied on the characteristics of the scars borders with hypertrophic scars remaining within the borders of the original wound and keloids extending beyond the original wound borders. Conclusion: The most important factor in hypertrophic scar and keloid formation is prevention. A key strategy for prevention of hypertrophic scarring and keloid development is to identify those patients predisposed to this wound healing response and to control the Inflammation that can trigger these scars. Primary goals of treatment include reducing the cosmetic appearance of these lesions and preventing their recurrence once treated.