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Keloid and Raised Scarring: Why Some Scars Grow Beyond the Original Wound

Name: Faciem Dermatology & Medical Clinic
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Keloid and hypertrophic scars form when healing skin lays down more collagen than the wound needed, leaving the scar raised above the surface. A hypertrophic scar stays inside the boundary of the original wound. A keloid pushes past that boundary into skin that was never injured, and can carry on growing for years. Both are more common in deeper skin tones.

This page sets out how keloid and hypertrophic scarring is assessed and managed at Faciem, and is reviewed for clinical accuracy.
Last reviewed: 14 September 2026.
Patient information only. Keloid scars can enlarge if they are treated inappropriately, so any plan follows a face-to-face consultation with Dr Prasad.

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TL;DR

Keloid and hypertrophic scars are both the result of excess collagen laid down while a wound heals. Hypertrophic scars stay within the original wound and often settle over one to two years; keloids spread into surrounding skin, seldom regress on their own, and can return after removal. Both are far more common in Black, South Asian and East Asian skin, and most begin between the ages of ten and thirty. Treatment aims to flatten, soften and settle symptoms; surgery on its own frequently leaves a keloid larger than it was.

About the Condition

What Is Keloid & Raised Scarring?

A raised scar is a scar that sits above the skin surface because healing produced more collagen than the wound needed. Hypertrophic scars stay within the borders of the original injury and may flatten with time. Keloid scars grow outwards into uninjured skin, continue enlarging after the wound itself has healed, and seldom settle without treatment.

How do you tell a keloid from a hypertrophic scar?

The boundary of the original wound separates the two. A hypertrophic scar is raised, firm and often red or darker than the skin around it, but it stops where the wound stopped; it usually appears within weeks of the injury and frequently flattens and pales over one to two years. A keloid crosses that boundary into skin that was never damaged, typically with a smooth, shiny, rubbery surface and claw-like extensions. Keloids may surface months after the event, keep enlarging for years, and rarely regress unaided. Both can itch, sting or feel tender, and both restrict movement where they cross a joint. The sites seen most often are the chest, shoulders, upper back, earlobes after piercing, and the jaw and neck.

Who is most likely to develop keloid scars?

Keloid scarring is far more common in people of Black, African, Afro-Caribbean, South Asian, East Asian and Hispanic heritage, and uncommon in very fair skin. Most keloids begin between the ages of ten and thirty, when skin tension and healing activity are at their highest, and the risk falls with age. Family history counts, and anyone who has already formed one keloid has a much higher chance of forming another — the single most useful thing to know before an elective procedure, a piercing or a tattoo. Site matters as well: the chest, shoulders and earlobes carry high risk, while eyelids and palms almost never keloid. Skin tone itself is described on the Fitzpatrick scale, and keloid risk rises with it — Fitzpatrick IV to VI skin forms keloids far more readily than Fitzpatrick I to II. That scale also guides treatment, because on deeper skin tones any laser used on a scar needs its wavelength, energy and interval chosen to limit post-inflammatory pigmentation, and a patch test carries more weight before the full treatment goes ahead.

What else can look like a keloid?

Not every lump at a healed wound is a keloid. Hypertrophic scars are the commonest mix-up, and the distinction changes what treatment is appropriate. Dermatofibromas are firm nodules, often on the legs, that dimple inwards when pinched. Cysts, skin tags and other benign lesions can sit at the site of an old injury. Raised scarring driven by repeated ingrowing hairs at the nape of the neck has a name of its own, acne keloidalis nuchae. Occasionally a growth within an old scar needs investigating in its own right, which is why any scar that changes should be examined.

Causes & Contributing Factors

What Causes Keloid & Raised Scarring?

Keloid and raised scarring is caused by collagen production carrying on after a wound has closed. Genetics sets how likely you are to scar this way. Tension on the skin, how inflamed the wound became and how long it took to heal then decide how likely a raised scar is at a particular site.

Genetic predisposition

Family history of keloids is common, and the tendency runs strongly with deeper skin tones. Anyone who has formed one keloid has a much higher chance of forming another after any future injury, however minor it seems.

Prolonged inflammation during healing

Wounds that stay inflamed — through infection, tension or repeated irritation — over-produce collagen more readily. It is why acne on the chest and back, and recurrent ingrowing hairs at the beard line or nape, so often end in raised scars.

Skin tension and site

Areas under constant tension or movement, such as the chest, shoulders and upper back, form raised scars far more readily than low-tension sites. The earlobe is the exception, keloiding frequently after piercing despite little tension on it.

Age

Keloids most often develop between the ages of ten and thirty, when healing activity is at its most vigorous. The likelihood falls steadily with increasing age, although keloids already formed will persist.

Trauma of any kind

Surgery, piercings, tattoos, burns, insect bites, vaccinations and acne can each trigger a keloid in a susceptible person. Sometimes no injury is remembered at all, a pattern recognised as spontaneous keloid formation.

Treatments We Offer

How Keloid & Raised Scarring Is Treated at Faciem

Assessment and treatment of keloid and raised scarring is available at Faciem Dermatology & Medical Clinic on Kensington Church St, London, led by Dr Prasad. The aim is to flatten the scar, soften it and settle the itching or tenderness, because excision on its own frequently produces a keloid larger than the one removed. What may be prescribed after examination ranges from creams intended to flatten the scar and medicated tape applied over it, to injected treatment and laser. Improvement builds over months, and the scar is identified as keloid or hypertrophic first, since that changes what is appropriate.

Dermatology Consultation

A keloid and a hypertrophic scar can look alike and behave nothing alike, and treating one as though it were the other can enlarge it. Dr Prasad examines the scar, confirms which it is and sets the plan before treatment starts.

Best for: diagnosis and planning before any treatment

Read about Dermatology Consultation

Vascular Laser

Vascular laser targets the blood vessels feeding an active scar, which may reduce redness, thickness and itch. Evidence suggests it achieves more alongside injected treatment than it does used alone.

Best for: red, active raised scars alongside injections

Read about Vascular Laser

Medical-Grade Skincare

Settling whatever caused the scarring — acne, folliculitis or ingrowing hairs — stops new scars forming while existing ones are treated. Marks and pigment left in the skin around a scar are managed here too.

Best for: preventing further scars and treating marks

Read about Medical-Grade Skincare

Injected anti-inflammatory treatment such as triamcinolone is a mainstay of keloid management and may be considered after examination. Where repeated ingrowing hairs at the nape or beard line keep triggering new raised scars, reducing the hair itself with laser hair removal can take away the trigger, once any active scarring has been assessed. Surgery is seldom advised for keloids, because excision alone often leaves a larger scar behind. Suitability is decided at a face-to-face consultation with Dr Prasad, and results vary between individuals.

When to Seek Medical Advice

When Should You See a Doctor About a Raised Scar?

See a doctor about a raised scar while it is still active. Red, itchy or growing scars respond better to treatment than long-established ones, and treating early can stop a small raised scar becoming a large one. Any scar that changes character should be examined, whatever its age.

Worth getting checked

Conditions that can look similar

Self-Care & Prevention

Caring for a Raised Scar Between Appointments

Prevention is where home care earns its place in raised scarring, particularly if you already know you scar this way. Protecting healing wounds, avoiding unnecessary trauma to the skin and treating inflammatory conditions early all lower the chance of a raised scar forming in the first place.

Do

Avoid

This is general guidance and does not replace individual assessment. What suits you depends on whether your scar is keloid or hypertrophic, how active it is now, and where on the body it sits.

Why Patients Choose Faciem

Raised Scarring Identified Before It Is Treated

Keloid scarring is one of the few skin problems where the wrong treatment reliably makes matters worse, since excision alone frequently leaves a scar larger than the one removed. At Faciem the scar is examined and identified before any intervention is planned.

Experience & Expertise

Why Does a Keloid Need Assessing Before Treatment?

Keloid scarring is unusual in that intervening badly is worse than not intervening at all. Excising a keloid without adjunctive treatment often produces a scar larger than the one removed, because the surgery is itself another injury in someone who over-heals. Identifying keloid from hypertrophic scar therefore comes first: hypertrophic scars frequently settle with time and conservative measures, while keloids need active management and seldom regress alone. Timing counts too, since red, active scars respond better than mature ones. Dr Prasad, a GMC-registered doctor with 20 years’ experience in dermatology, establishes which type of scar is present, how active it is, and which combination of treatment suits your skin.

Dr Anamica Prasad — MBChB (1999), Dip Dermatology (2001), MRCGP, DFFP, DRCOG · a GMC-registered doctor
Member of the Joint Council for Cosmetic Practitioners (JCCP), British Medical Laser Association (BMLA), Royal Society of Medicine and the Aesthetic Complications Group
Clinic operated by Derma Medical UK Ltd, registered with the Care Quality Commission for diagnostic and screening procedures, surgical procedures, and treatment of disease, disorder or injury · CQC Location ID 1-25573003746
Face-to-face medical consultation and examination before any scar treatment is planned
20 years’ experience in dermatology, treating scarring across every skin tone

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Keloid & Raised Scarring FAQs

Your Questions, Answered

Common questions about keloid and hypertrophic scarring, answered. Anything specific to your own scar is settled at a face-to-face consultation.

What causes keloid scars?

Keloid scars are caused by healing that keeps producing collagen after the wound has already closed. Genetic predisposition is the main driver, which is why keloids are far more common in deeper skin tones and in people aged between ten and thirty. Prolonged inflammation, tension on the skin and the site of the injury all raise the risk, and a keloid can follow something as small as an insect bite.

Can I exercise or go back to work after keloid scar treatment?

Most people go back to work the same day as a keloid injection, since the appointment takes minutes and needs no recovery time. The treated scar can ache, look swollen or blanch for 24 to 48 hours. Keep the site dry for 24 hours, leave the gym, hot yoga and swimming for 48 hours, and avoid clothing or straps that rub the scar for the rest of that week.

How do you get rid of a keloid scar?

Keloid treatment aims to flatten the scar, soften it and relieve symptoms, not to erase it. After examination, treatment may include prescribed creams intended to flatten the scar, medicated tape applied over it, or injected anti-inflammatory treatment, sometimes with vascular laser alongside. Surgery on its own is seldom advised, because excising a keloid frequently produces a larger one. Improvement builds over months.

How many treatments does a keloid scar need?

The number of treatments a keloid needs depends on its cause, size and how many scars are involved, and a plan is set out at your assessment. Good results are often seen after two treatment appointments, though keloids are generally managed as a course with review in between. Results vary between individuals, and follow-up matters because keloids can return.

Can a keloid on the earlobe be removed after piercing?

Earlobe keloids are the recognised exception to the general rule against excising keloids. Where an earlobe keloid is large, surgery may be recommended, with steroid injection afterwards to reduce the chance of it returning. Smaller earlobe keloids are usually managed without surgery. Whether this route suits your own scar is decided after Dr Prasad has examined it.

Can I have keloid scar treatment while pregnant or breastfeeding?

Keloid treatment is usually deferred during pregnancy and breastfeeding. Injected steroid and laser are not routinely used in pregnancy, so active treatment is generally postponed until afterwards, and a keloid that has been present for years can wait those months. What carries on in the meantime is the conservative side: silicone gel or sheeting worn daily, sun protection, and keeping any new wound clean and free from tension. Tell Dr Prasad at the consultation if you are pregnant, trying to conceive or breastfeeding.

What determines the cost of keloid scar treatment?

Cost depends on how many scars are involved, their size and activity, and which treatments are appropriate — injections, laser, prescribed topical care, or a combination of them. Keloids are managed as a course over months, so the plan is costed across several appointments. Fees for the initial dermatology consultation are published on that page, and your own treatment costs are confirmed before anything goes ahead.

Sources & Further Reading

Keloid scars — causes and treatment — NHS
Keloid and hypertrophic scars — DermNet NZ
Acne patient information leaflet, including scarring — British Association of Dermatologists

These are general sources of patient information and do not replace individual medical assessment. Your own diagnosis and treatment plan are established at consultation.

Keloid & Raised Scarring in Kensington, London

A Doctor-Led Clinic in the Heart of Kensington

Scar treatment is a course, not a single visit: appointments sit weeks apart with review in between, so easy travel counts. Faciem Dermatology & Medical Clinic is on Kensington Church St, a few minutes’ walk from High Street Kensington station and around ten from Notting Hill Gate, with Kensington council underground parking close by. Opening hours run Monday to Saturday, 10am–7pm, which makes appointments before or after work workable for patients coming in from Chelsea, Notting Hill, Holland Park and across West London.

Plan Your Visit

Faciem Dermatology & Medical Clinic
Phone: +44 20 7131 3539
7 Kensington Church St, London W8 4LF, United Kingdom
Tube: High Street Kensington (few minutes’ walk) · Notting Hill Gate (~10 minutes)
Parking: Kensington council underground car park nearby
Open Monday–Saturday, 10am–7pm · Sunday closed
Scar assessments bookable online; treatment planned only after examination
Consultation-first — no treatment without medical assessment
Serving Kensington, Chelsea, Notting Hill & Central London

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Related Conditions & Treatments

Acne Scarring

How acne leaves pitted, indented scars rather than raised ones, and why the two need different treatment.

Ingrowing Hair

Repeated ingrowing hairs at the nape and jawline are a common route into raised scarring, including acne keloidalis nuchae.

Lumps & Bumps

Cysts, dermatofibromas and other benign lumps that can be mistaken for a keloid, and how they are told apart.

Faciem Dermatology & Medical Clinic · Kensington

Have Your Scar Identified Before It Is Treated

Book a consultation with Dr Prasad at our Kensington clinic to find out whether your scar is keloid or hypertrophic, how active it is now, and what treatment is appropriate for your skin.

Prefer to talk? +44 20 7131 3539

Monday – Saturday	10am – 7pm
Sunday	Closed