Treating Scarring in Asian Skin: Hypertrophic Scars vs Keloids

Asian skin presents unique challenges when it comes to wound healing and scar formation. Understanding the differences between hypertrophic scars and keloids is crucial for effective treatment, especially considering the genetic predisposition of Asian populations to abnormal scarring patterns.

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Understanding Asian Skin and Scar Formation

Scar formation after skin injuries is often inevitable, but Asian skin types face particular challenges due to several physiological factors. 

Research reveals significant structural and physiological differences between Asian and Caucasian skin that directly impact the wound healing process.

Key Characteristics of Asian Skin:

Asian skin demonstrates distinct properties that influence scarring:

• Thicker dermis structure with higher collagen density at similar anatomical sites

• Increased fibroproliferative response during the healing process

• Prolonged inflammatory periods leading to enhanced erythema during wound healing

• Higher melanin production results in increased pigmentation risks

• Enhanced sebum secretion and fibroblast proliferation

• Extended scar maturation timeframes compared to other skin types

These factors contribute to Asian skin's increased susceptibility to developing both hypertrophic scars and keloids, making proper treatment selection essential.

What Are Hypertrophic Scars and Keloids?

Hypertrophic Scars:

Hypertrophic scars represent the body's overactive healing response but remain within the original wound boundaries. Key characteristics include:

• Raised, red appearance that stays within the injury site

• Excessive collagen production during healing

• Potential for improvement over time without intervention

• Associated symptoms like itching or mild discomfort

• Better treatment response compared to keloids

Keloids:

Keloids represent a more severe scarring condition that extends beyond the original wound site:

• Growth beyond wound margins into surrounding healthy skin

• Thick, raised texture that can continue growing over time

• Higher occurrence in darker skin tones and Asian populations

• Persistent nature requiring professional intervention

• Can develop from minor injuries that including acne, piercings, or small cuts

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Why Asian Skin Is More Prone to Keloids and Hypertrophic Scars?

Several interrelated factors increase the likelihood of abnormal scarring in Asian patients:

• Genetic predisposition to fibroproliferative disorders

• A greater inflammatory response following injury

• Environmental triggers, such as UV exposure and friction

• Higher levels of Transforming Growth Factor-beta (TGF-β) activity, contributing to uncontrolled collagen production

• Cultural factors like traditional remedies or delayed wound care may also influence scar outcomes

What is the treatment for keloids and hypertrophic scars?

At Dream Clinic, we offer advanced and clinically proven treatments to reduce the appearance of hypertrophic scars and keloids.

The choice of treatment depends on multiple factors that our specialists carefully evaluate:

Scar Characteristics:

• Size and extent of the scar tissue

• Location and anatomical considerations

• Severity and thickness of scarring

• Age and maturity of the scar

Patient-Specific Factors:

• Skin type and ethnic background

• Previous treatment history

• Individual healing patterns

• Lifestyle and expectations

Our dual-modality approach focuses on both collagen regulation and tissue remodeling, helping to flatten raised scars, reduce pigmentation, and restore smoother skin.

1. Steroid Injection

Intralesional steroid injections represent one of the most widely used and clinically proven treatments for problematic scars. This minimally invasive procedure involves injecting corticosteroids directly into the scar tissue, targeting the root cause of excessive scar formation.

How Steroid Injections Work

The treatment works through multiple mechanisms:

• Anti-inflammatory Action: Corticosteroids reduce inflammation within the scar tissue, which is often the driving force behind excessive growth.

• Collagen Regulation: The medication inhibits excessive collagen production, preventing the scar from becoming thicker and more prominent.

• Symptom Relief: Patients often experience immediate relief from itching, pain, and tension associated with hypertrophic scars and keloids.

• Growth Prevention: Regular treatments help prevent further scar enlargement and progression.

Benefits of Steroid Injections

• Proven clinical effectiveness

• Minimal downtime required

• Localized treatment with precise delivery

• Suitable for various scar types

• Can be combined with other treatments

• Relatively affordable option

2. Fotona SP Dynamis NX-Line Laser

The Fotona SP Dynamis NX-Line Laser ablative laser is an advanced option for treating hypertrophic scars and keloids to provide an effective result. 

How Fotona SP Dynamis NX-Line Laser Works

• Layer-by-Layer Removal: The Fotona SP Dynamis NX-Line Laser carefully vaporizes outer layers of scar tissue, reducing height and thickness systematically.

• Collagen Remodeling: The thermal energy stimulates natural collagen production and reorganization, improving skin texture and flexibility.

• Precision Targeting: Advanced laser technology ensures minimal damage to surrounding healthy tissue.

• Natural Healing Stimulation: The controlled injury triggers the body's natural healing response, promoting smoother skin regeneration.

Benefits of Fotona SP Dynamis NX-Line Laser

• Superior Precision: Fotona's advanced technology allows for extremely precise treatment with minimal collateral damage.

• Faster Recovery: Compared to traditional surgical methods, laser treatment offers significantly shorter recovery times.

• Comprehensive Results: Addresses both the appearance and texture of scars simultaneously.

• Versatile Application: Effective for various scar types and sizes.

• Minimal Side Effects: Reduced risk of complications compared to more invasive procedures.

Aspect	Steroid Injection	Fotona SP Dynamis NX-Line Laser
Procedure Type	Minimally invasive procedure involving direct injection into scar tissue	Ablative laser treatment
How It Works	Reduces inflammation- Inhibits excessive collagen production Relieves itching, pain, and tension Prevents further scar enlargement	Vaporizes outer layers of scar tissue Stimulates collagen remodeling Triggers a natural healing response
Target Area	Injected directly into scar tissue	Targets scar tissue from the surface
Benefits	Proven clinical effectiveness Minimal downtime Localized, precise delivery Suitable for various scar types Combines with other treatments Relatively affordable	Superior precision Faster recovery compared to surgery Improves texture and flexibility Versatile application Minimal side effects
Best For	Problematic hypertrophic scars and keloids	Hypertrophic scars and keloids
Treatment Frequency	Multiple sessions spaced several weeks apart	Used in combination with other treatments (no exact frequency stated)

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How to prevent Hypertrophic Scars and Keloids?

While not all scars can be prevented, certain measures can help minimize the risk of developing hypertrophic scars and keloids:

• Proper wound care: Keeping wounds clean and moist can promote better healing.

• Avoiding unnecessary skin trauma: Be cautious with piercings, tattoos, and other skin procedures.

• Using silicone gel or sheets on healing wounds: These can help reduce the risk of excessive scarring.

Conclusion

At Dream Clinic, we understand that dealing with hypertrophic scars and keloids requires personalized care and expert guidance. Whether you're considering the steroid injections or the Fotona SP Dynamis NX-Line Laser therapy, our experienced team will help you navigate these treatment options with confidence.

Both steroid injections and laser therapy have revolutionized scar treatment, offering safe and effective alternatives to traditional surgical approaches. During your consultation, our skin specialist in Penang will thoroughly evaluate your scar characteristics, discuss your lifestyle considerations, and understand your aesthetic goals to recommend the most suitable treatment approach.

Don't let problematic scars affect your confidence any longer. Schedule an appointment with us to begin your comprehensive consultation and discover how our advanced scar treatment options can help restore your skin's natural beauty and your peace of mind.

FAQs

What's the difference between keloids and hypertrophic scars?

Hypertrophic scars remain within the boundaries of the original wound and typically improve over time. They're raised but don't grow beyond the injured area. Keloid scars, on the other hand, extend beyond the original wound margins and can continue growing months or even years after the initial injury. Keloids rarely improve without treatment and are more likely to recur after removal.

How long does steroid injection treatment take to show results?

Steroid injection results typically become visible after 4-6 weeks, with continued improvement over several months. Most patients require 3-6 treatment sessions spaced 4-6 weeks apart. The scar gradually becomes flatter, softer, and less noticeable with each session.

Can keloids come back after treatment?

Yes, keloids have a tendency to recur, which is why combination therapy and ongoing maintenance are often recommended. Keloids are likely to persist without spontaneous resolution and prove resistant to treatment. Regular follow-up appointments help monitor and address any early signs of regrowth.

Are these treatments suitable for all skin types?

Steroid injections are generally safe for all skin types and colors. Fotona laser treatment is also suitable for most skin types, but individuals with very dark skin may require special precautions to prevent pigmentation changes. 

Reference

1.Ledon, J. A., Savas, J., Franca, K., Chacon, A., & Nouri, K. (2013). Intralesional Treatment for keloids and Hypertrophic Scars: a review. Dermatologic Surgery, 39(12), 1745–1757. https://doi.org/10.1111/dsu.12346

2.Nast, A., Eming, S., Fluhr, J., Fritz, K., Gauglitz, G., Hohenleutner, S., Panizzon, R. G., Sebastian, G., Sporbeck, B., & Koller, J. (2012). German S2k guidelines for the therapy of pathological scars (hypertrophic scars and keloids). Journal Der Deutschen Dermatologischen Gesellschaft, 10(10), 747–760. https://doi.org/10.1111/j.1610-0387.2012.08012.x

3.Jung, K. E., Jung, K. H., Park, Y. M., Lee, J. Y., Kim, T. Y., Kim, H. O., & Kim, H. S. (2013). A Split-face comparison of ablative fractional lasers (CO2and Er:YAG) in Asian patients; postprocedure erythema, pain and patient’s satisfaction. Journal of Cosmetic and Laser Therapy, 15(2), 70–73. https://doi.org/10.3109/14764172.2012.75905