Managing Hypertrophic and Keloid Scars

Learn about scars and how to treat them in this helpful Q&A, written by Dr Rod Tucker, PhD freelance medical writer.

What is a scar?

Our skin is the largest organ in the body. It consists of two layers: an outer epidermis that covers an inner dermis, which contains blood vessels, nerves and a structural, supportive protein known as collagen. Minor traumas to the skin from cuts or grazes may heal completely because only the epidermis is affected. However, incisions from surgical procedures, lacerations, piercings and burns, may cause injury to the deeper layer of the dermis. The skin repairs itself by first removing the damaged tissue and then replacing it. This newly formed area of tissue is known as a scar and is never as strong as the original skin. Scientists don’t fully understand how a scar is formed but it is likely to be the result of an imbalance between the removal and repair processes.

Hypertrophic and keloid scars

During the repair process, if the body produces too much collagen, the tissue rises above the level of the skin producing hypertrophic and keloid scars. Hypertrophic scars are usually red in colour and thicken only in the area of the original injury whereas keloids grow and spread much further than the wound. Between 40 and 70 percent1 of patients will develop hypertrophic scars following a surgical procedure and up to 91 percent of those after a burn1. Hypertrophic scars usually develop four to eight weeks after surgery and can continue to grow over the next six months though, fortunately, many will shrink over time. The most common sites for hypertrophic scars are the shoulders, neck, knees and ankles and they are often red in colour. Keloids are far less common after surgery, affecting up to 15 percent of people2 but can occur after minor injuries to the skin from insect bites, vaccinations and body piercing. Keloids are also more frequently seen in those with African skin types and may develop several years after the original injury. Common sites for keloids are the chest, shoulders, earlobes and cheeks.

Treatment of scars

For many people, scars are more than just a cosmetic problem, causing pain and irritation and even restricting movement, particularly if near or over a joint. Scars can also have a negative psychological impact3 upon sufferers especially if the scars are visible.

There are several different treatment options including topical silicone gel and sheets, surgical removal of the scar, injection of steroids into the scar and laser or radiotherapy. Silicone sheets and gel, and steroid injections are considered the gold standard of scar prevention and treatment.


Dermatix®, available in the UK, comes in clear and fabric sheets consisting of long chains of siloxanes – a mixture of silicone and other elements all linked together. The sheets are soft and self-adhesive, easily attaching to the contours of the skin and are designed to be left on for up to 24 hours, and can be reused.

Dermatix® silicone gel and sheets are available on prescription or may be purchased at, or from your local pharmacy.



  1. Gauglitz G et al. Mol Med 17 (1- 2) 113-125, Jan-Feb 2011.
  2. Kuei-Chang Hsu et al. Wounds 2017;29(5):154–158. Vol 29, Issue 5, May 2017. Published by HMP Communications LLC (HMP)
  3. Bock O et al. Arch Dermatol Res (2006) 297: 433–438
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