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The skin is the largest organ of the body and is a seamless covering for blood vessels, muscles, nerves, tendons and bones. Scars result when there is damage to the skin by trauma, friction injury, surgery, burns, infection or chronic irritation. Scarring is the natural part of the healing process after injury. Scars never go away or become non-scars.

A scar is made up of disordered collagen rather than the highly structured collagen of undamaged skin. The scar process becomes maximum three to six months after injury. Over the next six months and for several years, scars begin to soften, lose the intense red inflammatory response and may flatten. This is called scar maturation. 

Hypertrophic scars

Hypertrophic scars are scars that are raised above the wound and appear thick and red at the site of the injury. These kinds of scars remain confined to the wound itself and are caused by injury to the deep dermal layers of the skin. Excessive amounts of collagen are produced during healing at the site of the injury, causing the thick, raised, red scars. Hypertrophic scars remain confined to the wound itself, differing from keloids in this respect.

The appearance of hypertrophic scars can improve over the course of six months to two years; however, the appearance of these scars may greatly impact self-esteem. Excessive itching is a frequent side effect and the scars may limit range of motion.

Hypertrophic scars may be treated with skin grafting, laser surgery, scar revision, injections or compression garments. Shriners Children's Ohio pediatric plastic surgeons are specialized in treating hypertrophic scars and will work with the family and child to determine a treatment plan to achieve the best possible outcome.

Hypertrophic scar


Keloids are the result of excessive growth of scar tissue at the site of a healed skin injury. They expand beyond the margins of the original wound and no one is sure what causes them. Anyone can develop a keloid formation from a wound to the skin, whether the cause is a burn, surgery, ear piercing or even acne.

While keloids are not usually harmful or dangerous, they can grow seemingly out of control and cause pervasive scarring and greatly impact self-esteem. When keloids get very large, they can reduce range of motion and impact day-to-day functions.

There is no single cure for keloid scarring that works for every patient, but several treatment options are available.

Keloid scarKeloid before and after