Scars & Keloids
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Darker Skin
Keloids are significantly more common
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Age Factor
The peak onset for keloid development is during the second and third decades of life
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40% to 90%
Hypertrophic scarring occurs in patients following surgery or trauma
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70%+
of patients with keloids report associated symptoms such as pruritus (itching) or localized pain
UNDERSTANDING Scars & Keloids
Precision Scar Revision: Beyond the Surface of Wound Healing
For many in Birmingham and Hoover, a scar is more than a mark on the skin—it is a lasting reminder of an injury, surgery, or inflammatory event that can impact both physical comfort and self-confidence. Whether you are dealing with the persistent itching of a raised keloid or the textural irregularities of an atrophic acne scar, scarring is a complex biological process. At Inverness Dermatology, we move beyond the “wait and see” approach to provide a clinical path to scar revision that prioritizes the restoration of both skin function and aesthetic harmony.
The Anatomy of a Scar
Clinically, a scar is the result of the body’s natural Wound Healing Response, specifically a disorder of Extracellular Matrix Remodeling. When the deeper dermal layer is injured, the body prioritizes rapid closure over structural perfection, depositing dense bundles of Type I and Type III Collagen. In the case of Keloids and Hypertrophic Scars, this process goes into overdrive, with fibroblasts continuing to produce collagen long after the wound has closed. This results in a raised, often symptomatic lesion that can be firm, tender, or restricted in movement.
Targeted Scar Protocols at Inverness Dermatology
We categorize Scars and Keloids (ICD-10: L91.0) by their morphology and inflammatory state to ensure the most effective medical intervention.
Our team focuses on Biological Modulation. A critical pillar of our trust promise is the Multi-Modal Approach. Because no two scars are identical, we combine traditional medical interventions with advanced energy devices to remodel the tissue from the inside out. For keloid-prone patients, we emphasize Recurrence Prevention, utilizing a proactive clinical strategy to ensure that treating a scar does not trigger further excessive collagen growth.
CLINICAL DETAILS
A Breakdown of Scars & Keloids
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Keloid
Firm, raised growths that extend beyond the original wound margins; highly prone to recurrence.
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Hypertrophic Scar
Raised, red scars that remain within the wound boundaries; often occur in areas of high skin tension.
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Atrophic Scar
Sunken or "pitted" scars caused by a loss of collagen; most common following acne or chickenpox.
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Contracture Scar
Rigid scars that tighten the skin, often following a burn injury, which can restrict movement of joints.
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Striae Distensae
Clinically known as "stretch marks"; these are linear scars caused by the rapid stretching of the dermis during growth or pregnancy.
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Acne Scarring
A specialized sub-type that can be atrophic (ice pick, boxcar, rolling) or hypertrophic, resulting from inflammatory acne lesions.
EVIDENCE-BASED CARE
Our Treatment Approach
Board-certified dermatologists are specially trained to diagnose and provide customized treatments.
The Science of Skin Renewal (How Treatment Works)
- Our approach focuses on Collagen Remodeling and Vascular Suppression. We incorporate Intralesional Corticosteroids or 5-Fluorouracil to flatten raised tissue by inhibiting overactive fibroblasts.
- For redness and structural irregularities, we utilize Advanced Energy Devices (such as Pulsed-Dye or Fractional CO2 lasers) to target the micro-vasculature and break down rigid scar tissue. This process stimulates the production of more organized, flexible collagen, gradually softening the scar’s appearance and restoring the skin’s natural elasticity and texture.
Scars & Keloids FAQ
Clinical answers from our board-certified dermatologists.
While both are raised, a hypertrophic scar stays within the boundaries of the original injury and may flatten over time. A keloid grows beyond the original wound boundaries, acts like a benign tumor, and will not regress on its own.
While no scar can be “deleted” to return the skin to its exact pre-injury state, clinical revision can significantly improve the texture, height, and color. Our goal is to make the scar as inconspicuous as possible while restoring comfort and mobility.
Scars, particularly keloids, are biologically active. The excessive collagen production and underlying inflammation can compress small nerve fibers in the dermis, leading to sensations of itching, tenderness, or “shooting” pains.
Surgical excision of a keloid alone has a recurrence rate of nearly 50-100%. At Inverness Dermatology, we only perform excision in combination with “adjuvant” therapies—such as immediate steroid injections or pressure therapy—to suppress the regrowth of the keloid.
