Is this a keloid or hypertrophic scar? What are my treatment options? (photos)

This scar was caused by a self harm incident. I recently got a consultation from a plastics office however, the consultant was not the physician. She said my scar was a keloid but according to the definitions I thought this was a hypertrophic scar. She said my best options was scar revision and when I mentioned kenalog injections she quickly turned it down. I would like to know if steroids injectons or scar revision is approriate?

Doctor Answers 3

Intralesional Corticosteroid Injections Can Work Well To Flatten Hypertrophic Scars

First, let me express how sorry I am that you are suffering from this now, and that you had suffered so deeply in the past to have caused you to come to this situation. From the photos, it appears that you are correct and do in fact have hypertrophic scars. By definition, hypertrophic scars are elevated scars THAT REMAIN WITHIN THE CONFINES OF THE ORIGINAL WOUND. (True keloid scars are elevated but "spill" out beyond the margins of the original wound). Hypertrophic scars may be flattened with the use of appropriate concenrations of intralesional corticosteroids, such as triamcinolone acetonide suspension. Not uncommonly, simply flattening the scars is enough of an improvement to please many people. If flattening is still not enough, microneedling may be used to better blend the tone and texture of the central scar and the "railroad tracks" stitch marks around it. Best to consult with a board certified aesthetic physician with experience and expertise in all forms of scar treatments. I wish you the very best.

New York Dermatologic Surgeon
4.8 out of 5 stars 22 reviews

Hypertrophic Scar/Keloid -- Pulsed Dye Laser/VBeam, 5fu/steroids, Fraxel/Viva, CO2, Aerolase

Hypertrophic scarring/keloids should be treated in a combination approach with lasers along with steroid/5fu injections. Medical tattooing can be used for improvement with pigmentation. Please see an expert. Best, Dr. Emer

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 158 reviews

Is this a keloid or hypertrophic scar? What are my treatment options?

Thank you for your question and I am sorry to hear of your scarring issue.  Depending on the duration of the scar I would recommend conservative management with pressure therapy, silicone sheets, and cortisone injections.  Though none of these will remove the scarring from the cut or the sutures it may flatten them sufficiently to not be as troublesome.  Hope this helps.

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 38 reviews

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