Hypertrophic scars/Keloids

Patients may report a history of trauma, surgery, or skin inflammation, such as acne or piercings, leading to raised, itchy, or painful scars. They may also mention family history, particularly with keloids, which are more common in darker skin types. 

Hypertrophic scars appear as raised, firm, reddish lesions confined to the wound site. Keloids are firm, irregular, and extend beyond the original wound boundary, often forming in areas like the chest, shoulders, and earlobes. 

Treatment for hypertrophic scars includes:

1. Silicone gel sheets (12–24 hours/day, for 3–6 months).

2. Intralesional corticosteroid injections (e.g., Triamcinolone acetonide 10–40 mg/mL every 4–6 weeks).

For keloids:

1. Cryotherapy combined with corticosteroid injections for smaller lesions.

2. Laser therapy for reducing pigmentation and size.

3. 5-Fluorouracil (5-FU) injections (50 mg/mL, weekly or biweekly) as an adjunct to corticosteroids.

Other options include surgical excision, often combined with radiation therapy, though recurrence is common.