Keloids are raised and thickened scar tissue that extends beyond the original wound, often firm and sometimes itchy or tender.

When the skin heals after an injury, surgery or inflammation, it often leaves behind a visible reminder. Scars are part of the body’s natural healing process and form when the skin repairs itself by producing new collagen fibres. For most people, this tissue eventually softens and fades with time.

However, sometimes the healing process becomes exaggerated. Instead of stopping once the wound closes, the body continues to produce collagen. This leads to a raised and firm growth known as a keloid. It can extend beyond the original wound and vary in size and colour. It may also cause itching and discomfort.

While neither a scar nor a keloid is dangerous, both can affect confidence and comfort, especially when they develop on visible areas such as the face, chest or shoulders.

Fortunately, modern dermatological care offers many options to help smooth, flatten or lighten a scar, allowing the skin to look and feel more even.

Types of Scars (including keloids)

Not all scars look or behave the same. Their appearance depends on the depth of the injury, your skin type and how your body heals. Some of the common types of scars are:

TYPE	DESCRIPTION	APPEARANCE
Flat scars	These are the most common and often the least noticeable over time.	Initially pink or red, gradually fading to match the surrounding skin tone Smooth and level with the rest of the skin May feel slightly tight or dry during the early stages of healing
Atrophic scars	These occur when the skin cannot produce enough collagen during healing, leaving behind a small depression.	Fine edges that may look wider in certain lights Sunken or pitted texture Often appear on the face, chest or back
Hypertrophic scars	These develop when the body produces too much collagen, but the growth remains within the boundaries of the original wound.	Firm, raised and reddish in colour Can feel tight or itchy, especially in the early stages May flatten and fade with time or treatment
Keloids	A keloid forms when collagen production continues even after the wound has healed, leading to tissue that grows beyond the original injury.	Extends past the wound edges Thick, raised and shiny surface May appear pink, red or darker than the surrounding skin Can cause persistent itching, tenderness or discomfort
Contracture scars	These occur after deep burns or extensive injuries that damage the skin and underlying tissue.	Tight, shiny and stretched skin that may limit movement Often darker or lighter than the surrounding area Commonly found around the joints or large surface areas

Who is more prone to Scarring or Keloid formation?

Some people are naturally more likely to develop noticeable scars or keloids due to their skin type, genetic traits or healing patterns. By recognising these factors, you can help yourself to take early steps to prevent severe scarring.

These factors include, but are not limited to:

RISK FACTOR	DESCRIPTION
Age	Younger individuals tend to produce more collagen, which can lead to thicker scars or keloids. Older skin may heal more slowly, sometimes resulting in flatter and paler scars.
Genetic predisposition	Certain families tend to form keloids or thick scars. If a parent or sibling has keloids, the likelihood of developing them is higher.
Skin type	People with darker skin tones are more prone to keloid formation. Healing in these skin types can sometimes trigger excess collagen production.
Type of injury	Scars are more likely to form in areas where the skin is under tension, such as the chest, shoulders, back or earlobes. Deep cuts, burns, surgical wounds, piercings and severe acne can leave more noticeable scars.
History or scars or keloids	If you have developed keloids or hypertrophic scars before, new injuries are at a higher risk of forming similar marks.
Delayed healing	Wounds that heal slowly or become infected may stimulate more collagen production, increasing the chance of raised scars.

How are Scars (including keloids) treated in Singapore?

Surgical scars can be effectively treated with personalised therapies to reduce thickness, improve texture and minimise visibility.

The treatment for scars often depends on their type, size, location and symptoms. Treatments focus on improving appearance, reducing discomfort and preventing further growth.

Our dermatologist often combines several approaches for the best results, such as:

Topical treatments

Silicone gels or sheets – applied directly to the scar to help flatten and soften raised tissue
Topical corticosteroids – reduce inflammation and limit excessive collagen production
Moisturisers and emollients – keep the skin hydrated, promoting smoother healing

Procedural treatments

Microneedling – stimulates collagen remodelling, particularly for depressed or pitted scars
Steroid injections – injected directly into keloids or hypertrophic scars to shrink and soften tissue
Laser therapy – improves colour, texture and reduces redness, while also flattening raised scars

Cryotherapy – a freezing technique that helps flatten smaller keloids by destroying excess scar tissue using controlled cold application
Radiotherapy – used alone or with surgery to reduce keloid regrowth by slowing collagen production, this method is rarely performed in Singapore and reserved for resistant cases
Combination therapy – many scars respond best to a combination of approaches, such as laser therapy, corticosteroid injections and silicone gel application, tailored to each patient’s needs

Surgical treatment

Scar revision surgery – removes or repositions scar tissue for a more natural appearance

Lifestyle and supportive care

Avoiding trauma or friction on the scar to minimise irritation
Protecting the area from sun exposure to prevent pigmentation changes
Following our dermatologist's instructions carefully for post-procedure care

Summary

Early intervention and proper post-treatment care help minimise scarring, improve healing and achieve the best long-term results.

Scars are natural results of the skin’s healing process, but they can sometimes be persistent, raised or affect confidence and comfort. By understanding the different types, how they develop and the treatment options available, you can take informed steps to manage them effectively.

At Dermatology Collective, our dermatologists offer personalised care, combining modern treatments with practical guidance to help restore the skin’s appearance and comfort. Early assessment and intervention often lead to better outcomes, reducing the likelihood of persistence or worsening scars.

Healthy and balanced skin is possible at any age and professional support can make a meaningful difference in both appearance and confidence. Call us today to book a personalised consultation and discover how we can help improve your skin health.

Frequently Asked Questions (FAQs)

Can scars go away on their own?

Mild scars often fade over time, but keloids and hypertrophic scars usually persist without treatment. Early intervention can improve their appearance and prevent further growth.

Will treatment completely remove a scar or keloid?

No treatment can guarantee complete removal, but many options can significantly flatten, soften or lighten scars, making them less noticeable and more comfortable.

Are keloids painful or itchy?

Keloids may cause itching, tenderness or discomfort, especially when they are actively growing. Treatments like steroid injections or silicone sheets can reduce these symptoms.

Can scars or keloids return after treatment?

Yes, particularly keloids, which tend to regrow. Our dermatologists may recommend combination therapy or ongoing management to reduce recurrence.

How long does treatment take to show results?

Results vary depending on scar type, size and treatment method. Some improvements may be seen within weeks, while others, like laser therapy or steroid injections, may require several months of gradual progress.

Is treatment suitable for all skin types?

Yes, but treatment plans are tailored to your skin tone, scar type and location. Our dermatologists will consider risks such as pigmentation changes and design strategies to minimise side effects.

Can lifestyle changes help improve scars?

Protecting scars from sun exposure, avoiding trauma and following aftercare instructions can support healing and enhance treatment results.

When should I see a dermatologist?

Seek professional care if a scar or keloid is painful, rapidly growing, itchy or causing functional or cosmetic concern. Remember that early assessment allows for more effective treatment and better long-term outcomes.