Scars almost always result from trauma of some kind (surgery, accident, disease) and are a natural part of the healing process. The more and the deeper the skin is damaged, the longer and more complicated the rebuilding process – and the greater chance that the patient will be left with a noticeable scar.

A normal scar usually develops during the first 48 hours after wound closure and can fade between 3 and 12 months with an average time of 7 months. Various factors can interfere with the wound healing process and alter it in some way to cause an “overhealing” or continuation of the scarring process. As a result, an abnormal scar develops, which may have the following effects:

  • Grows bigger
  • Remains red/dark and raised without fading
  • Causes discomfort, itching or pain
  • Restricts the movement of a joint
  • Causes distress because of its appearance

Common types of abnormal scars

 Widespread stretched scars

Appear when the fine lines of surgical scars gradually become stretched and widened. Typically flat, pale, soft and symptomless scars. No elevation, thickening or nodularity which distinguishes them from hypertrophic scars.

Linear hypertrophic scars

Red, raised and sometimes itchy. Confined to the border of the original surgery or trauma. Mature to have an elevated, slightly rope-like appearance with increased width. Full maturation can take up to two years.

Widespread hypertrophic scars

Common after a burn. Widespread red, raised and sometimes itchy scars that remain within the borders of the original burn. Can develop contractures if they cross joints or skin creases at right angles.

Atrophic scars

Flat and depressed below the surrounding skin. Generally small and often round with an indented or inverted center. Commonly arise after acne or chickenpox.

Keloid scars

Focally raised, itchy scars that extend over normal tissue. May develop up to several years after injury and do not regress without treatment. Surgical excision is often followed by recurrence.

Keloid Scar