With every wound there are certain individual and environmental factors that influence abnormal scarring (e.g. keloid scars or hypertrophic scars) which make the choice of appropriate scar treatment and scar prevention essential.

Age and Hormonal Influence

Although keloid scars and hypertrophic scars can develop at any age, they tend to develop more readily during and after puberty. Menopause tends to prompt the regression of scarring and pregnancy tends to exacerbate it. Scars from thyroid surgery (thyroidectomy scars) can be problematic due to hormonal changes.

Genetic Factors and Previous History

Abnormal scarring is 15 times more likely to occur in darker-skinned individuals. Keloid scar formation occurs in areas of high melanocyte concentration and is rarely found on the eyelids, genitalia, soles and palms. Individuals with ginger hair and freckles are also at an increased risk of keloid scars. People with a previous personal history of keloid scarring are more likely to scar again in an abnormal fashion and those with a family history are also at an increased risk.

Scar location and surgery technique

Scars over or near muscles that are particularly active often spread or become more visible than the scars formed on less active areas. Skin and wound tension during wound repair is also a contributor to increased scarring.

Wound Infection

Wound infection increases the risk of abnormal scarring.

Type of Skin Injury

A variety of different types of skin injuries can lead to the development of keloid and hypertrophic scarring including surgery, burns and inflammatory skin processes such as acne, psoriasis and chicken pox.

Silicone based products, like Strataderm silicone gel, have been recommended by International clinical recommendations on scar management and have become the standard care for plastic surgeons when it comes to scar treatment and prevention of keloid and hypertrophic scars. Silicone is not only considered first line treatment for scars but it is also recommended for use in conjunction with other scar therapy options, such as corticosteroid injections and pressure garments.

Read more about how to avoid abnormal scars.

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