Keloid & Hypertrophic Scar Treatments
Learn how injections, lasers, cryotherapy, and silicone therapy are combined to flatten and soften raised scars with safe, evidence-based care.
Understanding Keloid & Hypertrophic Scars:
What are Keloid and Hypertrophic Scars and why do they form?
Scars often carry personal stories, but some can feel heavier than others. Among the most challenging are keloid and hypertrophic scars—raised, firm marks that may cause discomfort, itching, or self-consciousness. At Canada Scar Clinic, our mission is to help patients in Toronto and Richmond Hill improve not only the appearance but also the comfort of these scars through advanced, evidence-based treatments.
Hypertrophic scars remain confined to the original wound, often developing after surgery, burns, or trauma. While they may gradually soften, they can still cause cosmetic and functional concerns. Keloids, by contrast, extend beyond the edges of the wound, growing into nearby skin. They are more persistent, may recur after treatment, and frequently cause symptoms such as itching, burning, or tenderness.
The reason these scars form lies in the body’s natural healing response. When skin is injured, collagen production surges to repair the tissue. In some individuals, this process goes into “overdrive,” creating thickened scar tissue that rises above the skin. Genetics, skin type, and the site of injury all influence whether someone develops a hypertrophic scar, a keloid, or a flatter, less visible mark.
While these scars are medically harmless, their impact is often deeper—affecting clothing choices, confidence, and even daily comfort when they occur on the chest, shoulders, ears, or joints. That’s why targeted, personalized treatment makes such a difference: it’s not just about skin but about restoring confidence and quality of life.
Treatment Approaches for Keloid & Hypertrophic Scars
Treating keloid and hypertrophic scars is never a “one-size-fits-all” process. Each scar has its own character—some are small and itchy, others large and firm, and many carry both cosmetic and physical burdens. That’s why at Canada Scar Clinic, we draw from a wide range of advanced therapies, often combining them for more predictable, lasting results.
One of the most effective foundations of care is intralesional corticosteroid injections. These injections help soften scar tissue, flatten raised areas, and reduce symptoms like itching or tenderness. For stubborn cases, we may add agents such as 5-fluorouracil to increase effectiveness. Cryotherapy is another option, especially useful for smaller keloids such as those on the earlobes. By freezing scar tissue, it can shrink the scar’s bulk, and when paired with steroid injections, outcomes are often enhanced.
For patients struggling with redness, thickness, or textural changes, fractional and vascular lasers play a central role. These devices deliver controlled energy into the skin, stimulating collagen remodeling and breaking down excessive scar tissue. Lasers are staged over several sessions, allowing gradual but meaningful improvements. Similarly, HIFU (High-Intensity Focused Ultrasound) penetrates deeper layers of the skin to remodel tissue from within, offering another non-invasive tool to reshape scar structure.
Textured or pit-like components of hypertrophic scars sometimes respond well to TCA CROSS. This precise technique places a high concentration of acid directly into small scar areas, triggering a controlled healing response that smooths uneven surfaces over time. For at-home management, we often recommend silicone gel or sheeting. Though simple, consistent use of silicone helps hydrate scar tissue, reduce redness, and gradually soften raised areas when worn for several months.
Because scars differ widely, most patients require a series of 3–6 sessions, typically spaced 4–8 weeks apart. Silicone therapy is used daily for ongoing support, and in the case of keloids, maintenance visits may be needed to help reduce recurrence.
Downtime is generally minimal. Injections may leave mild tenderness for a day, cryotherapy can cause temporary blistering or scabbing that heals within a week or two, and laser sessions usually bring a few days of redness and swelling. HIFU causes only mild tenderness for up to 72 hours, while TCA CROSS produces small scabs that last around 5–7 days. Silicone therapy, on the other hand, is completely non-invasive and can be used without interrupting daily routines. We also emphasize sun protection, which is essential to protect healing skin and prevent unwanted pigmentation.
It’s important to recognize the limitations of treatment. Keloids in particular are known for their high recurrence rates—even after surgery or energy-based therapies. This is why combination protocols and follow-up sessions are so important. Additionally, patients with darker skin tones may need customized laser or peel settings to avoid pigment changes. Finally, results take time. Flattening, softening, and color improvement usually develop gradually over several months, requiring both patience and commitment.
The good news is that with the right plan, keloid and hypertrophic scars can often be transformed from thick, uncomfortable reminders into softer, flatter marks that are easier to live with. At Canada Scar Clinic, our goal is not just to change how a scar looks, but to help patients feel more comfortable in their own skin again.
The Latest Updates in Keloid & Hypertrophic Scar Treatment
Scar science continues to evolve, and so do the tools we use. Combination therapy—for example, pairing steroid injections with agents like 5-FU or bleomycin—has been shown to improve results compared with steroids alone. Intralesional cryotherapy now allows freezing scars from the inside out, making it especially useful for bulky keloids. We also see better outcomes when fractional CO₂ lasers are used to create micro-channels before steroid injections, allowing deeper absorption of medication. Even topical silicone gels are advancing, with new versions enriched with peptides or botanical agents to enhance scar softening and comfort.
What You Can Expect at Canada Scar Clinic
When you visit us, we start with a careful consultation. We’ll assess your scar’s type, location, and symptoms, review your medical history and skin tone, and then design a personalized plan that may combine several treatments for the best outcome. You’ll receive clear guidance on downtime, aftercare, and what results to expect—always realistic, never overpromised.
Our mission is simple: to make scars less visible, less uncomfortable, and less limiting. With the right care, scars can become softer, flatter, and easier to live with—so you can feel more confident in your own skin.
FAQs:
Will treatment results vary depending on my skin type or tone?
Yes. While treatments are effective across all skin tones, darker skin types may require customized laser or peel settings to avoid pigmentation changes. Our physician-led team carefully tailors protocols for safety and optimal results.
Can underlying medical conditions affect my treatment?
Certain conditions—such as diabetes, immune disorders, or use of medications like isotretinoin—can influence healing. During your consultation, we review your medical history to ensure your plan is safe and effective.
What does treatment feel like? Is it painful?
Most treatments are well tolerated. Injections feel like a brief pinch, lasers like a warm tingling, and cryotherapy a cold sensation. Topical numbing or cooling devices are available to keep you comfortable throughout your session.
What happens if my keloid comes back?
Keloids are known for their tendency to recur. This is why we design long-term strategies that may include maintenance visits, combination therapies, or at-home silicone use to reduce the chance of regrowth.