A keloid scar is a scar that grows beyond the boundaries of the original wound, becoming firm and raised. For those encountering it for the first time, the most common questions are usually similar: Do I really need to treat it? And once it forms, will it get bigger? To answer directly, keloids tend to progress rather than subside on their own over time, so early attention can help with management.
In the past, many people were unfamiliar with keloid scars or thought they could be left alone. However, recently, the number of people visiting Yonsei Star Dermatology Sinchon to improve keloid scars has been steadily increasing. Therefore, we have selected four frequently asked questions and will systematically organize the information, from causes to differentiation methods.
Why and Where Do Keloids Tend to Form?
It is difficult to pinpoint a single exact cause. However, keloid scars often form on the chest, shoulders, back, jaw, and abdomen. Looking at the commonalities of these areas, it is reported that keloid formation is related to an environment where the activity of fibroblasts in the wound area is increased, or where the skin experiences greater tension, causing fibroblasts to produce more collagen fibers than necessary.
Therefore, it can be helpful to somewhat limit strength training that can increase tension and blood supply to keloid areas. However, it is difficult to unconditionally advise those who enjoy exercise to stop. At our clinic, we recommend continuing exercise while periodically undergoing keloid treatment.
What is the Difference Between Keloid Scars and Hypertrophic Scars?
Although they may look similar, keloid scars and hypertrophic scars are different types of scars. The biggest difference lies in their progression.
| Classification | Hypertrophic Scar | Keloid Scar |
|---|---|---|
| Occurrence | Anyone with severe wounds | Those with a keloid predisposition |
| Extent | Grows within the boundaries of the wound | Grows excessively beyond the boundaries of the wound |
| Course | Most stabilize over time | Can progress and gradually increase in size |
Hypertrophic scars can appear in anyone with severe wounds and grow within the boundaries of the original wound. In contrast, keloid scars occur in individuals with a keloid predisposition and are characterized by growing excessively beyond the wound's borders and continuing to progress.
While most hypertrophic scars stabilize on their own over time, keloid scars can progress and gradually increase in size, making early attention important if possible.
If you have any questions, please feel free to leave them via Keloid Scar Chat Consultation.
If a Keloid Suddenly Appears
Occasionally, some individuals report developing keloid scars after major trauma from surgery or an accident, even though they never had them before. It is common for people to be unaware of their keloid predisposition until a major trauma triggers keloid formation, at which point they discover it.
Therefore, if you suspect you have a keloid predisposition, it is necessary to consult thoroughly with your doctor when deciding on surgical procedures. Paying attention to the following points in daily life can also be helpful:
- Be careful to avoid even small injuries if possible.
- Reduce postures or exercises that put excessive tension on keloid areas.
- Inform medical staff in advance about a keloid predisposition before trauma or surgery.
- If a scar grows or if itching or pain develops, do not delay seeking attention.
If you are concerned about the progression of the keloid scar itself, it is safer to determine the management approach after assessing its extent.
How to Differentiate Between Acne and Keloids When Confused
Acne and keloid scars have relatively distinct characteristics, making them not difficult to distinguish. Acne is accompanied by inflammation, so there may be warmth or pain when touched, and it feels elastic and soft.
In contrast, keloids can cause pain or itching as they grow and feel firm to the touch. If acne persists in the same spot for more than six months without disappearing, you might consider if it is a keloid scar. If you tend to develop acne scars easily, we recommend paying closer attention.
Keloid Treatment: Improvement and Recurrence Prevention Together
In keloid treatment, managing to prevent recurrence is as important as improving the scar. In the consultation room, it is not uncommon for patients to return because their scars grew back after trying to resolve them with a single procedure. Therefore, at our clinic, depending on the scar's condition, we consistently combine Triamcinolone Scar Injection and laser treatment to aim for both improvement and recurrence prevention.
Treatment effects and responses can vary individually depending on the scar's location, size, and constitution, so a thorough consultation with medical staff before starting is helpful.
In Summary
Keloid scars differ from hypertrophic scars or acne in their progression, so it is safer to confirm with an accurate diagnosis rather than trying to distinguish them yourself. It is reported that the earlier a progressing scar is addressed, the more helpful it is for management.
Inquire via chat consultation if you are curious whether your scar is a keloid
This article was reviewed by Chief Director Lee Sang-joo, a dermatologist who represents Yonsei Star Dermatology Sinchon, serves as an adjunct professor in the Department of Dermatology at Yonsei University College of Medicine, and will be the president of the Korean Dermatological Association in 2026, with extensive experience in pigment and scar treatment. View Chief Director Lee Sang-joo's Profile First published 2024-04-23 / Last reviewed July 23, 2026
This content contains general medical information, and the condition and progression of scars may vary from person to person. Please consult with a dermatologist for an accurate diagnosis and treatment plan.