When your wound starts to heal the body produces more collagen which gathers around the damaged tissue and seals it. However, in keloid scars the collagen production doesn’t stop and the scar extends beyond the borders of the original wound in the form of dense fibrous tissue.

Keloid scars are raised and range in consistency from soft and doughy to hard and rubbery. They can appear anywhere on the body although they usually form in the area of shoulders, cheeks, earlobes and neck area. Burn scars or infected lesions, including acne, are more likely to form keloids. Keloid scars sometimes itch and may be painful. Keloid scars are 15 times more likely to occur in darker-skinned individuals, may be familial, and tend to develop more readily during and after puberty.

While keloid scars are difficult to treat, combination treatments seem to be the most effective. International Clinical Recommendations on Scar Management highlight a primary role for silicone and intralesional corticosteroids in the management of a wide variety of abnormal scars including keloids. Silicone is also recommended as first-line prophylaxis for keloid scars. Other options include surgery (high risk of recurrence), radiotherapy, cryotherapy, and laser.

If your skin is keloid prone, you should avoid piercings, tattoo and any unnecessary incisions, such as plastic surgery. You should treat acne thoroughly to reduce lesions and potential for scarring or, if surgery is necessary, silicone may be combined with intralesional steroids or other treatments (above) to reduce the likelihood or size of keloid scarring.

Acne is the most common skin disorder, affecting around 15% of the adult population and up to 80% of adolescents. Facial scarring because of acne occurs to some degree in most cases. The majority of acne scars are flat and depressed below the surrounding skin (atrophic), generally small and often round with an indented or inverted centre. To prevent acne scars, do not pop, squeeze, or pick at acne; do not pull scabs of acne; seek treatment early for acne that does not respond to OTC medications.

Types of Acne Scars:

–          red and/or hyperpigmented marks: a post-inflammatory change that usually disappears in 6-12 months

–          acne scars – icepick: depressed scars, deep, narrow and sharp; usually too deep for dermabrasion or laser skin resurfacing

–          acne scars – boxcar: depressed scars, round with sharp edges

–          rolling acne scars: depressed scars, wavy texture in the skin

–          keloids and hypertrophic scars are raised acne scars that may become larger and more noticeable, sometimes painful and itchy.  

Silicone gel like Strataderm is effective for treatment of acne scars and prevention of keloids and hypertrophic scars. Other effective treatments for depressed acne scars include laser skin resurfacing, dermabrasion, scar surgery (punch excision, punch elevation, punch graft, subcutaneous incision), fillers, chemical peel, microdermabrasion and similar procedures that you should discuss with your dermatologist. For raised acne scars, like keloid and hypertrophic scars, your doctor might consider options like intralesional injections, cryotherapy, surgery, laser and light therapy. Your dermatologist will be able to create a treatment plan based on the type of your acne acne scars, results you can expect, and your medical history.

Acne Scars:


Acne is the most common skin disorder in the United States, affecting 40 to 50 million Americans.

It is caused by overproduction of oil, blockage of the follicles that release oil, and bacteria, called Propionibacterium acnes.

 Acne is not caused by chocolate, nuts, cola, pizza, potato chips or any other foods a person eats.

Acne scars are flat and depressed below the surrounding skin, generally small and often round with an indented or inverted centre.

To prevent scars, do not pop, squeeze, or pick at acne; seek treatment early for acne that does not respond to OTC medications.

How to Get Rid of Acne:

Acne Scar Treatment with Fractional CO2 Laser:

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