Hypertrophic Scar Treatment in Pune: How It Differs from Keloids?

The scar is raised, firm, and red. It has been months since the wound healed and it is not settling the way you expected. You have been told it is either a hypertrophic scar or a keloid — and that the treatment is the same. It is not. Hypertrophic scars and keloids look similar and are frequently confused, but they behave differently, respond to different treatments, and carry different risks if managed incorrectly. Getting the distinction right before any treatment begins is the difference between a scar that improves and a scar that is made worse. This guide explains the difference clearly, what treatments actually work for each type, and what patients in Pune can expect from scar revision at Dr. DC Plastic Surgery.

A hypertrophic scar is a raised, thick scar that stays within the boundary of the original wound and often improves on its own over 12 to 24 months. A keloid grows beyond the wound boundary, does not improve without treatment, and tends to recur. Treatment for hypertrophic scars includes silicone gel, compression, steroid injections, and laser. Keloids require a more aggressive combined approach. Misidentifying a keloid as a hypertrophic scar and treating it conservatively allows it to grow.

Hypertrophic Scar vs Keloid: The Key Differences

Understanding which type of raised scar you have determines everything about how it should be treated. These are the distinguishing features:

• Boundary behaviour: A hypertrophic scar stays within the margins of the original wound. A keloid actively grows beyond the wound edge, invading surrounding normal skin. This is the single most reliable distinguishing feature.
• Timeline: Hypertrophic scars typically appear within weeks of injury and may gradually improve over 12 to 24 months. Keloids can appear months after injury, continue growing for years, and do not spontaneously regress.
• Symptoms: Both can be itchy and tender. Keloids tend to be more persistently symptomatic, itching, burning, and pain are more common and more pronounced.
• Site preference: Hypertrophic scars can occur anywhere. Keloids have specific site preferences: earlobes, chest, upper back, shoulders, upper arms, and the jaw line are disproportionately affected. The central face is rarely affected by keloids.
• Recurrence after treatment: Hypertrophic scars respond well to treatment and have a lower recurrence rate. Keloids have a strong tendency to recur after excision alone, recurrence rates without adjuvant treatment are 50 to 80 percent.
• Skin type and genetics: Both conditions are more common in patients with darker skin types (Fitzpatrick IV to VI), which includes most Indian patients. Keloid formation also has a strong genetic component, a family history of keloids significantly increases personal risk.
  

Why the Correct Diagnosis Matters, and Why a Plastic Surgeon Should Make It?

The most common mistake in raised scar management in Pune and across India is treating a keloid as a hypertrophic scar. The practical consequence is: the keloid continues to grow while the patient waits for it to improve, and excision performed without adjuvant treatment causes a larger keloid to form in the wound.

A plastic surgeon with MCh or DNB Plastic Surgery training has the clinical experience to distinguish between hypertrophic scars and keloids through examination, history, and the pattern of the scar’s behaviour over time. This distinction is not always obvious in early presentations, and in uncertain cases the appropriate response is cautious monitoring rather than aggressive intervention.

Dr. Dhruv Chavan, plastic surgeon at Dr. DC Plastic Surgery in Pune, holds an MCh in Plastic Surgery and is a member of the Association of Plastic Surgeons of India (APSI). Patients from Kharadi, Baner, Hinjewadi, Viman Nagar, NIBM, Prabhat Road, and across Pune attend consultations at Dr. DC Plastic Surgery for assessment of raised, thickened, and problematic scars before any treatment is initiated.

For detailed information on keloid management specifically, the keloid treatment covers the combined treatment approach used for keloid scars at Dr. DC Plastic Surgery.

Treatment for Hypertrophic Scars

Hypertrophic scars are more responsive to treatment than keloids and carry a significantly lower recurrence risk. The treatment ladder moves from least to most invasive:

Silicone gel sheeting and topical silicone. The first-line treatment for hypertrophic scars. Silicone applied consistently over 12 to 24 hours per day for a minimum of 3 months reduces scar thickness, redness, and itching. Results are gradual but meaningful for early hypertrophic scars. This is a home-based treatment that is recommended alongside all other approaches.

Compression therapy. For hypertrophic scars over joints or large surface areas, pressure garments worn continuously over 6 to 12 months reduce scar bulk and encourage flattening. This is commonly used for post-burn hypertrophic scars and large post-surgical scars.

Intralesional steroid injections. Triamcinolone acetonide injected directly into the scar every 4 to 6 weeks reduces inflammation, softens the scar, and flattens its elevation. This is one of the most widely used treatments for hypertrophic scars. A course of 3 to 6 sessions is typically needed. Side effects include skin thinning and hypopigmentation (lightening of the skin around the injection site) if the steroid spreads beyond the scar, this is a relevant consideration for Indian patients with darker skin.

Pulsed dye laser (PDL). Targets the vascularity of the scar, reducing redness and improving texture. PDL is particularly effective for red, actively vascular hypertrophic scars and for reducing the itching and tenderness associated with them.

Fractional laser resurfacing. Once a hypertrophic scar has matured and stabilised, fractional laser improves surface texture, reduces thickness, and improves the overall appearance. Multiple sessions are typically required.

Surgical scar revision. For mature hypertrophic scars that have not responded to non-surgical management, surgical excision and careful re-closure under tension-free conditions can produce a significantly improved scar. The technique used depends on the location, orientation, and size of the scar.

Raised Scar in Pune That Is Not Settling? Get It Assessed Before It Gets Worse.

At Dr. DC Plastic Surgery, Dr. Dhruv Chavan assesses raised and problematic scars, distinguishes hypertrophic scars from keloids, and builds a treatment plan matched to the specific scar type. Early assessment leads to better outcomes.

Book a Scar Assessment Consultation | View the Scar Revision

How Hypertrophic Scar Treatment Differs from Keloid Treatment?

The treatment principles overlap but the key differences are significant:

Steroid injections: Used in both, but keloids typically require higher concentrations and more sessions. Hypertrophic scars respond faster and more completely.

Excision: Safe for hypertrophic scars with appropriate closure technique. In keloids, excision without adjuvant treatment (radiation, steroid injection, pressure) carries a 50 to 80 percent recurrence risk and the new scar is often larger than the original. Excision of a keloid should never be performed without a planned adjuvant protocol.

Laser: Effective for both, but the approach differs. Vascular laser reduces vascularity and symptoms in both scar types. Ablative laser has a risk of triggering recurrence in keloids and requires careful use.

Monitoring timeline: Hypertrophic scars can reasonably be observed for 12 months to see if spontaneous improvement occurs. Keloids that are growing should not be observed passively, growth is an indication for treatment.

Cost of Hypertrophic Scar Treatment in Pune

At Dr. DC Plastic Surgery, approximate cost ranges:

A personalised treatment plan and cost estimate is provided at consultation after the scar type, extent, and recommended approach are established. See the treatment pricing for general guidance.

What to Expect at Your Scar Assessment Consultation?

Patients who have been living with a raised or thickened scar often delay consultation because they are unsure whether anything can be done, or because they have been told to wait for it to settle on its own. At Dr. DC Plastic Surgery, a scar assessment consultation is a clear starting point, not a commitment to any treatment.

Dr. Dhruv Chavan examines the scar, takes a history of how it developed and how it has behaved since, and makes a clinical determination of scar type. You leave the consultation with a diagnosis, a recommended treatment approach, a realistic expectation of what improvement is achievable, and a cost estimate if treatment is appropriate.

If the scar should be observed rather than treated immediately, that is what is recommended. The consultation is a clinical assessment, not a treatment sales appointment.

Scar Revision Consultations Across All Six Pune Locations, Kharadi, Baner, NIBM, Pimple Saudagar, Prabhat Road, Pune Station

Dr. DC Plastic Surgery has six clinic locations across Pune. Patients from East Pune, West Pune, and central Pune can access a scar assessment at the clinic most convenient to them.

Find Your Nearest Dr. DC Clinic in Pune | Book a Scar Consultation

Frequently Asked Questions

My scar has been raised for two years. Is it too late to treat it?

No. Mature hypertrophic scars that have been present for years still respond to treatment. Fractional laser, steroid injections, and surgical revision are all applicable to established scars. The treatment approach for a mature scar differs slightly from an early one, but meaningful improvement is still achievable.

Can I treat my hypertrophic scar at home?

Silicone gel sheeting and topical silicone are home-based first-line treatments and are genuinely effective for early hypertrophic scars when used consistently. Over-the-counter silicone products are reasonable to start while arranging a consultation for a clinical assessment.

Will steroid injections lighten my skin?

Intralesional steroid injections carry a risk of localised hypopigmentation (skin lightening around the injection site) if the steroid spreads beyond the scar boundary. This is more noticeable in patients with darker skin. An experienced plastic surgeon injects precisely within the scar to minimise this risk.

How do I know if my raised scar is a keloid or a hypertrophic scar?

The most reliable sign: look at the scar boundary. If the raised area stays strictly within the margins of your original wound, it is more likely hypertrophic. If it has grown beyond the original wound edge into surrounding normal skin, it is more likely a keloid. A clinical assessment by a plastic surgeon confirms the diagnosis.

Is scar revision covered by insurance in India?

Scar revision is generally considered cosmetic and is not covered by standard health insurance in India. Exceptions may exist for functional impairment (such as a contracture scar affecting joint movement) or scars from documented workplace injuries. Your insurer should be consulted directly about your specific policy.

Do Not Wait for a Raised Scar to Improve on Its Own, Get It Assessed First

Whether your raised scar is hypertrophic or keloid determines everything about how it should be treated. Book a consultation with Dr. Dhruv Chavan, plastic surgeon in Pune, at Dr. DC Plastic Surgery. Leave with a clear diagnosis and a treatment plan that is matched to your specific scar.

Book Your Scar Consultation or call +91 99604 341 11