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Keloids and hypertrophic scarring

Dermal injury triggers a cascade that results in the deposition of a vascular collagen matrix that, as it accumulates, becomes a red, raised scar. As the matrix matures and remodels, the scar will become flatter and paler after 9 months (takes longer in children). However, sometimes healing does not follow the usual pattern and excessively lumpy raised scars occur. These scars fall into two main categories:

• Hypertrophic scars, which seem to follow a similar, but protracted, course to normal scars along with a tendency to involute.