Raised or recurrent scars
Hypertrophic scars and keloids may cause itching, pain, tenderness, or progressive growth. Previous treatment and recurrence history help guide the next approach.
Scar & Keloid Surgery
Scars may cause discomfort, restriction of movement, or concerns about appearance. Treatment begins by identifying the scar type, symptoms, and underlying cause. Surgery is one of several options, and the goal is improvement rather than a promise of scar-free skin.
Understand Scar TreatmentUnderstanding scars
Not all raised or symptomatic scars are the same.
Scar formation is part of normal wound healing. Some scars remain flat and gradually mature, while others become raised, thickened, painful, itchy, widened, or contracted. Their behaviour depends on the original injury, location, tissue tension, individual healing characteristics, and previous treatment.
Hypertrophic scars generally remain within the original wound boundaries and may improve over time. Keloids extend beyond the original injury and can continue to grow or recur after treatment. Contracture scars may restrict movement or distort nearby structures. These distinctions influence management.
A new, changing, ulcerated, bleeding, or otherwise suspicious lesion should not automatically be assumed to be a scar or keloid. Further assessment or biopsy may be appropriate before treatment.
Who may benefit
When should a scar be assessed?
Assessment may be appropriate when a scar causes symptoms, functional limitation, recurrent growth, or a concern that the patient wishes to discuss. Not every scar requires treatment.
Contracture & functional concerns
Scars that restrict movement or distort an eyelid, lip, or another important structure may require reconstructive assessment. Function and tissue requirements guide the plan.
Appearance & scar quality
Widened, depressed, irregular, or poorly positioned scars may be considered for revision. The likely improvement must be weighed against a new scar and the possibility of further treatment.
Scar maturity, skin characteristics, medical history, previous procedures, and the patient's goals are relevant. The decision to treat should be individual rather than based on appearance alone.
Individual treatment planning
The scar type and underlying problem determine the approach.
Consultation considers the original injury or operation, scar duration, symptoms, location, size, direction, tissue tension, previous treatments, and any effect on movement or nearby structures. The diagnosis and realistic treatment goals are discussed before recommending an intervention.
Some scars are best observed while they mature. Others may benefit from non-surgical treatment, surgery, or a combination. The aim may be symptom relief, improved function, reduced bulk, or improved scar quality. These goals are not interchangeable, and complete removal of visible scarring cannot be guaranteed.
Planning for keloid recurrence
Keloids can recur after treatment, particularly following excision alone. When surgery is considered, an appropriate postoperative or adjuvant strategy may be discussed according to the location, size, previous recurrence, and available treatment options. Further treatment and long-term follow-up may be necessary.
Scar revision and timing
Revision may involve changing the scar position, reducing tension, rearranging tissue, or addressing contracture. Timing depends on scar maturity, symptoms, function, and the underlying condition. Earlier treatment may be appropriate for selected functional problems, whereas elective cosmetic revision may benefit from allowing a scar to mature.
Treatment approaches
Surgical and non-surgical options.
Treatment is selected according to the diagnosis and individual circumstances. A combination may be appropriate, but no single technique reliably prevents recurrence or produces an invisible scar in every patient.
Non-surgical management
Options may include silicone-based treatment, pressure therapy where appropriate, intralesional injections, or selected laser-based approaches. The choice depends on scar type, symptoms, location, and access to suitable treatment. Benefits, side effects, and the need for repeated sessions should be discussed.
Surgical scar revision
Surgery may involve excision and careful re-closure, tissue rearrangement, or release of a contracture. Techniques are selected to address tissue tension, scar direction, functional requirements, and the available surrounding tissue. A new scar is unavoidable.
Keloid excision & adjuvant care
Selected keloids may be treated with excision combined with postoperative measures such as injections, pressure or silicone therapy, or radiotherapy in appropriately selected cases. Radiotherapy requires specialist assessment of benefits and risks and is not suitable for everyone. Recurrence remains possible despite combined treatment.
This overview is educational. The specific treatment options offered by Dr. Joe, including any adjuvant treatment or referral, will be confirmed during consultation rather than assumed from this list.
Recovery & follow-up
Scar treatment often requires ongoing care.
Recovery depends on the treatment performed. Surgical revision may involve dressings, wound-care instructions, temporary activity restrictions, and follow-up to assess healing. Swelling, bruising, discomfort, and temporary changes in sensation may occur.
Scar maturation continues over months, and the final appearance cannot be judged immediately after surgery. Keloid treatment may require repeated sessions or ongoing postoperative care. Follow-up is important because recurrence may develop after an initially satisfactory response.
Preparation
Bring relevant previous operative records, pathology when available, and details of prior scar treatments. Medical conditions, medications, supplements, nicotine use, and previous healing problems should be reviewed. Do not stop prescribed medication without clinical guidance.
When to seek medical advice
Increasing redness, warmth, swelling, discharge, fever, wound separation, or escalating pain warrants timely assessment. Rapidly progressive symptoms or suspected infection should not be managed through a routine online enquiry.
Safety & limitations
Understanding the trade-offs.
Scar treatment cannot restore completely unscarred skin. The likely benefit must be considered alongside the possibility of recurrence, additional scarring, and treatment-specific complications.
Healing & new scars
Bleeding, infection, delayed wound healing, wound separation, altered sensation, and unfavourable scarring may occur after surgery. The revised scar may widen, thicken, or remain noticeable.
Recurrence & further treatment
Keloids may recur even after combined treatment. Hypertrophic scars may also remain symptomatic or require additional care. Further procedures cannot guarantee a permanent correction.
Treatment-specific risks
Injections may cause pigment changes, skin thinning, or other local effects. Laser treatment and radiotherapy have their own indications and risks. These should be discussed with the treating specialist when relevant.
Observation or non-surgical management may be preferable in some circumstances. An informed consultation includes the option of not proceeding with surgery.
Clinical results
Scar treatment in clinical context.
Clinical photographs may illustrate changes in scar thickness, symptoms, contracture, or appearance. Each case should include the diagnosis, treatment sequence, and follow-up period. A photograph cannot demonstrate symptom relief or guarantee that a keloid will not recur.
View Patient ResultsFeatured clinical case
BeforeImage pending
AfterImage pending
Clinical photographs and case details will be added here. Diagnosis · Treatment · Follow-up
Surgeon-led care
A considered approach to scar treatment.
Dr. Joe Areejunthawat is a board-certified plastic surgeon in Bangkok. His approach begins with understanding the scar, symptoms, and individual circumstances before recommending treatment.
The discussion includes potential benefits, limitations, recurrence, and alternatives, with referral or multidisciplinary care when appropriate.
About Dr. JoeYour consultation
Seeking scar or keloid assessment?
Share your concern, previous treatment history, and available records or photographs. Dr. Joe can assess whether treatment is appropriate and discuss the options, limitations, and follow-up requirements. Online enquiries are not suitable for emergencies.