Hypertrophic acne scars and keloids both form as raised marks from severe acne, but they differ in size, growth, and how they behave on the skin. Hypertrophic scars stay within the original spot of the pimple or wound, while keloids grow bigger and spread into nearby skin.
Both types happen when the body makes too much collagen while healing. Collagen is the protein that helps repair skin damage. After a bad acne breakout, the healing process can go overboard. For hypertrophic scars, this extra collagen piles up but does not go past the edges of the first injury. They often look red or pink and feel firm or bumpy. These scars usually show up a few weeks or months after the acne heals. Over time, many of them get smaller on their own, sometimes fading a lot within six months to a couple of years.
Keloids act differently. They start like hypertrophic scars but keep growing for months or even years. They push beyond the original acne spot, forming shiny, dome-shaped lumps that can be darker in color. Keloids often itch or hurt and are more common on the chest, back, shoulders, or earlobes. People with darker skin tones and a family history of them face higher risk.
You might see hypertrophic scars from acne on the face, since that is where pimples often hit hardest. Keloids from acne are rarer on the face but can appear there too. Both can come from other skin injuries like cuts, burns, or piercings.
Treatment options overlap for both, but keloids are tougher to handle. Doctors often start with steroid shots to shrink the scar by breaking down extra collagen. Silicone sheets or gels can soften them over time. Pressure therapy, like wearing tight bandages, helps prevent growth. For stubborn cases, laser treatments improve color and texture. Surgery removes them, but keloids have a high chance of coming back bigger, so it is not always the first choice. Topical retinoids, like vitamin A creams, speed up skin turnover and may help once the scar flattens.
Hypertrophic scars respond better to these methods and might not need much help if they fade naturally. Early care, like controlling acne to avoid picking pimples, prevents both from forming in the first place.
Sources
https://sozoclinic.sg/acne-scars/hypertrophic/
https://www.kins-clinic.com/blogs/what-are-the-main-acne-scar-types-a-skin-friendly-guide-with-treatment-options
https://slmdskincare.com/blogs/learn/the-5-kinds-of-acne-scars-how-to-treat-each-type
https://theskininvestmentclinic.com/skin-conditions/hypertrophic-scars/
https://dermatologycollective.sg/scars-keloids/
https://www.urgentcarefl.com/blog/scar-report-different-types-scars-scar-treatment-options/
https://revelusdermatology.com/cosmetic/keloid-treatment/
