Hypertrophic Scar vs. Keloid: The Expert’s Guide to Identifying Your Scar
Critical Timing: Why I Look at the Clock
When I evaluate a scar, the first thing I look at is the timeline. The window for intervention is completely different for a hypertrophic scar vs. keloid. I’ve found that hypertrophic scars often show the most improvement during the first year, making long-term care absolutely vital.
For keloid scars, timing is even more critical because they don't follow the rules. They can keep growing long after the normal healing process should have ended. I use my expertise to assess whether it's safe to intervene or if a treatment might accidentally trigger more growth.
How to Tell What You’re Dealing With
If you’re sitting at home trying to figure out the difference between hypertrophic and keloid tissue, I want you to ask yourself these questions:
Did the scar stay within the edges of the original injury?
If the answer is yes, it’s likely hypertrophic. If it spread out like a liquid into healthy skin, it’s probably a keloid.
Did it keep growing months after injury?
Keloids are persistent; they can keep expanding for years. Are hypertrophic scars permanent? They are, but unlike keloids, they usually stop growing and may even start to flatten out on their own over time.
Is the scar tender, itchy, or shiny?
Both can be itchy, but in my experience, keloid scars are much more likely to feel painful, tight, or sensitive to the touch.
Do you have a history of keloids?
If you’ve had one before, you’re at a much higher risk for future ones—even from something as small as a vaccine shot or a tiny scratch.
If you’re still unsure, don’t worry—you’re not alone. Most of my clients struggle to tell them apart, and that’s exactly why I’m here. You don’t have to figure this out by yourself.
Why This Distinction Matters to Me
At Natalia Mejia Skin, I never rush. I always take the time to listen to your skin before choosing a path. The reason is simple: keloids and hypertrophic scars might look similar, but they behave like total opposites.
Treatments that I love for a hypertrophic scar—like microneedling or camouflage tattooing—can actually make a keloid worse if they aren't handled with extreme care. This is why I insist on a deep dive into what is paramedical tattooingand the specifics of camouflage tattoo procedures before we even touch your skin. Identifying the scar type is always my first step.
Supporting Your Healing from the Inside Out
I believe that both keloids and hypertrophic scars need the right environment to improve. I always emphasize the benefits of hydration; your skin needs moisture to repair itself properly.
I also focus on the role of nutrition. What you put in your body supports your natural healing and helps minimize excessive scarring, especially if you’re someone who is naturally predisposed to keloids.
Common Locations for Hypertrophic Scars After Surgery
Hypertrophic scars frequently develop after surgical procedures, particularly in areas of tension. Breast reduction scars commonly develop hypertrophic characteristics, especially around incision lines subject to movement and tension.
Similarly, liposuction scars can become hypertrophic when proper healing protocols aren't followed. Understanding the 5 most common complications after liposuction includes recognizing when normal scars progress to hypertrophic formation.
What I Can Do for You
If you’re struggling with a scar, I can help. But I don't believe in "one-size-fits-all" solutions.
For Hypertrophic Scars: I use a regenerative approach that I’ve seen transform skin texture and color:
Microneedling with growth factors or stem cells to rebuild the tissue.
Organic peels to smooth out the surface.
Plasma energy to jumpstart the repair process.
Scar camouflage tattooing (once the tissue is stable) to blend the scar into your natural skin tone.
For Keloid Scars: I take a much more cautious, personalized route. I do not tattoo directly over keloids. Instead, I focus on:
Gentle regeneration to help reduce redness and thickness.
Topical support to calm down inflammation.
Referrals to top NYC dermatologists for cortisone or laser if I feel that's your best next step.
Honest, realistic goals. Not every keloid will disappear, but I can help make them manageable and much less noticeable.
Special Considerations for My Reconstruction Clients
If you’re coming to me for areola tattoo reconstruction, I have to be incredibly vigilant. Procedures like 3D areola tattoo design involve multiple punctures, which could trigger a keloid in prone individuals. Whether we're discussing nipple reconstruction vs. nipple tattoo options, I make your keloid risk a primary part of our conversation.
Stretch Mark Treatments
The same applies to stretch mark tattoo camouflage. Before we start, I evaluate your skin for any hypertrophic or keloid tendencies. Understanding the healing process and potential side effects is vital, especially when we are calculating the cost of camouflage stretch marks and the safety protocols needed for your specific skin type.
A Personal Reminder from Me
I know how frustrating it is when a scar doesn't heal the way you wanted it to—especially if it’s a constant reminder of a difficult time. But I want you to hear this: your scar is not a flaw.
It’s a map of how your body tried to heal you. My job is simply to help that process along, lovingly and professionally.
You Deserve to Feel Good in Your Skin
Every scar tells a story, and I’m here to honor yours. Whether you need scar camouflage tattoo, scar revision, or nipple reconstruction, getting the identification right is my foundation for your success.
If you’re tired of guessing, I invite you to book a consultation with me. I’ll take the time to assess your skin and explain exactly what we can do, step by step.
With love,
Natalia Mejia Specializing in scar regeneration, camouflage, and confidence restoration. Based in New York City