Raised and firm
The scar is higher than the surrounding skin, firm to the touch, but does not extend beyond the wound or stitch.
CONDITION / SKIN AND SCARS
Hypertrophic facial scars.
Hypertrophic facial scars are thick, raised scars that do not extend beyond the boundaries of the former wound. They often fade and flatten over time, and non-surgical treatment helps make them less noticeable; if needed, it is combined with surgery.
CONCEPTUAL VISUALIZATION- What it is
- A thick, dense scar that remains within the boundaries of the former wound.
- What it is not
- It is not a keloid: a keloid grows beyond the wound over time and usually does not flatten on its own.
- Will it go away on its own
- Often fades and flattens over time; scars change up to 2 years and longer.
- Who treats it
- Plastic surgeon together with a dermatologist.
01 / WHAT IS ITWhat is
What is
Hypertrophic scar on the face.
A wound that has reached the deep layer of the skin — the reticular dermis — heals with a scar. Sometimes after skin trauma, too much scar tissue forms, and the scar becomes thick, dense, and raised above the skin. Such a scar is called hypertrophic.
The main feature is that it remains within the boundaries of the former wound. This distinguishes it from a keloid, which over time becomes larger than the original wound and usually does not flatten without treatment. A hypertrophic scar, on the other hand, often fades and flattens over time, although scars can change for up to 2 years or longer.
On the face, such a scar is particularly noticeable: it cannot be hidden under clothing, it may itch or hurt, and near the eye or mouth — it can pull on the skin. International guidelines state that hypertrophic scars and keloids can seriously affect mood and social interaction.
It is not necessary to wait for the scar to change on its own: even if the wound healed poorly, the appearance of the scar can be improved.
This is general information. The doctor will tell you what will suit you after the examination.
02 / SIGNSHow does it look
How does it look
hypertrophic scar.
A scar appears at the site of a wound or stitch and gradually thickens. It's important not only how it looks, but also whether it interferes with the eye, mouth, or facial expressions.
Red or dark
The scar may be pink, red, purple, or darker than the skin; over time, the color often fades.
It itches or hurts
The scar may itch, hurt, or simply be uncomfortable — this should be mentioned to a doctor.
Pulls on the eyelid or lip
If the scar pulls the skin near the eye or mouth and changes facial features, this is already a scar deformity.
Cicatricial deformation of the faceGrows beyond the wound
If the scar "crawls" onto healthy skin and continues to grow, this is most likely a keloid — it is treated differently.
Keloid scars on the face03 / REASONSWhy scar
Why scar
it becomes thick.
Among the causes that contribute to hypertrophic scars, reviews mention tension on the wound or scar, general factors (for example, high pressure), heredity, and lifestyle. On the face, the type of skin, the location of the scar, and conditions that slow healing also matter.
Injuries and cuts
A wound after injury, especially if it healed slowly or poorly, can leave a thick scar.
Scars after injuries and cuts on the faceOperations
A scar after a facial incision may thicken. The risk is reduced by proper incision placement, careful suturing, and wound care.
Scars after operations on the faceBurns
A deep burn or a burn that healed slowly can leave a thick scar: systematic review lists burn severity and healing time among risk factors.
Scars after facial burnsTension
Tension on a wound or scar contributes to the thickening of the scar. Therefore, incisions on the face are planned so that tension is as minimal as possible, and a fresh scar is recommended to use tape.
04 / SEEK MEDICAL ADVICE
When to seek medical advice?
A hypertrophic scar on the face usually does not require emergency care: this is a planned situation. But if the injury or burn has just occurred, immediate assistance is needed.
103 immediately if:
- bleeding from a wound that does not stop;
- blood beats in a stream;
- a deep or large wound on the face;
- a fragment or glass is stuck in the wound - do not remove it yourself;
- fresh facial burn;
- acid, other chemical or electric burn.
Do not delay a visit to the doctor:
On the same day: the scar or wound is swollen, red, and increasingly painful, warm to the touch, or oozing pus; you were bitten by a person or animal. Planned: If the scar is thick, itchy, has been painful for a long time or aches, pulls the skin near the eye or mouth, or simply bothers you — make an appointment for a consultation.
05 / DIAGNOSTICSAs defined,
As defined,
What kind of scar is this.
- Conversation
When and after what the scar appeared, how the wound healed, whether it is still growing, and if there have been keloids before.
- Review
The doctor evaluates the thickness, color, and firmness of the scar, whether it extends beyond the wound, and whether it pulls on the eyelid or lip.
- Differentiate from a keloid
Treatment depends on this. Guidelines also recommend differentiating the scar from similar skin formations, including tumors.
- Photo
For planning and to compare how the scar changes over time.
06 / TREATMENTHow we treat
How we treat
Hypertrophic facial scars.
Completely removing a scar is impossible: the goal is to make it flatter, softer, and lighter. The choice depends on whether the scar tightens the skin: if the tightening is strong, surgery is the first choice; if not, non-surgical treatment. International recommendations advise combining several methods.
01
Without surgery
The basis of treatment for most hypertrophic facial scars.
- Silicone
- Silicone gels or sheets are considered the first choice by international guidelines. In a Cochrane review of 20 studies (873 participants), silicone reduced thickness and improved the color of the scar, but the quality of these studies is low.
- Less tension and sun exposure
- For a fresh scar, tape, moisturizing, and sun protection are recommended: cover the scar for at least a year and use SPF 30 or higher cream.
- Injections into the scar
- The medicine, for example a steroid, is administered directly into the scar. In a review of 25 randomized studies, injections on average reduced scar manifestations by 64.1%, physical methods by 29.9%, and topical agents by 34%; the authors write that injections may be more effective. Possible side effects include thinning of the skin and vascular "spider veins," so the dose and frequency are determined by a doctor.
- Laser
- An international consensus of 26 dermatologists and plastic surgeons named lasers as the first-line therapy for scars after injuries. The result depends on the type of laser and the skin: according to a review of randomized studies, on lighter skin, lasers may provide more benefit.
- Camouflage
- Special creams and powders help make the scar less noticeable while treatment continues.
02
Surgery
When the scar tightens the skin or remains coarse despite treatment.
- Excision and redistribution of tension
- The scar is excised and the wound is closed with local tissues so that the new suture lies with less tension and along the natural lines of the face.
- Together with other methods
- The operation is combined with silicone, injections, or laser: the guidelines recommend this combination for persistent scars.
- Lipofilling
- Autologous fat is injected under the scar. In a review of 23 studies (1,326 patients) after burns and injuries, the quality of scars improved both according to patients and doctors.
03
Timing and monitoring
- Initially — non-surgical
- Invasive and surgical methods are recommended for persistent scars at a later stage; the exception is a scar that strongly tightens the skin.
- Long-term monitoring
- After any treatment, a scar should be shown to a doctor over a long period of time.
- Without a single prescription
- Reviews emphasize: there is no universal method for facial scars, and there is still little high-quality research specifically on the head and neck. The plan is made for each individual.
- support
- If the scar depresses the mood, talking to a psychotherapist also helps - you can tell the doctor about it.
07 / AT THE VALIKHNOVSKYI INSTITUTE
How
How
we treat it.
Hypertrophic facial scars at the Doctor Valikhnovskyi Surgery Institute are treated under the “New Face” program, while laser, IPL, and scar care fall under the “Rehabilitation after aesthetic surgeries” program, with their own equipment and dermatologist supervision.
CLINIC SERVICE
A new face
Form, symmetry, facial expressions and functions after injuries, wounds, burns, removal of tumors and congenital changes.
View service
What we do for this condition
- Fractional CO2 laser — to make the scar smoother, softer, and less noticeable; treatment can start early, and the number of sessions is determined by the doctor.
- IPL — intense pulsed light for redness and pigmentation of the scar.
- Scar care — the dermatologist will select silicone gel, sheets, or tape and explain how to use them.
- Monitoring scar maturation — at follow-up examinations, the doctor monitors the scar and timely suggests laser or other treatments if it begins to thicken or darken.
- Injections into the scar — as prescribed by the doctor, either separately or after excision.
- Excision and local flaps — the scar is excised and closed with local facial tissues that are close in color and texture.
- Lipofilling — microfat and nanofat under the scar — for texture, color, and softness of the scar tissue.
Rostislav Valikhnovskyi
Plastic surgeon, candidate of medical sciences, founder of Dr. Valikhnovskyi Institute of Surgery.
Publications by topic
- "Correction of cicatricial deformation of the frontal area: surgical methods and results of own research" — Hospital Surgery, 2025 (DOI).
How treatment works with us
- Photo onlineSend a close-up photo of the scar and the face front and side; if the scar is near the eye or mouth — also in motion.
- ConsultationScar examination, differentiation from keloid, assessment of tension and whether the scar interferes with facial expression.
- PlanWhat to do now — silicone, injections, laser — and whether surgery will be needed later.
- TreatmentProcedures separately or in combination, often in several sessions with breaks.
- SupervisionFollow-up reviews: the plan is adjusted while the scar matures.
08 / QUESTIONS AND ANSWERSCommon
Common
questions
Short answers. What is right for you, the doctor will tell you during the consultation.
How does a hypertrophic scar differ from a keloid?
A hypertrophic scar stays within the wound and often flattens over time. A keloid becomes larger than the wound itself and usually does not flatten without treatment. A doctor can accurately distinguish them during an examination.
When can you start treating a facial scar?
Silicone, tape, and sun protection are recommended for a freshly healed scar. Surgery and other invasive methods are advised for persistent scars; earlier surgery is performed if the scar significantly restricts the eyelid or lip. The doctor will tell you when and how to start specifically in your case during the examination.
Do silicone sheets help?
Guidelines consider silicone the first choice, and studies have shown it reduces thickness and improves the color of the scar. However, the quality of these studies is low, so silicone is often combined with other methods.
Are injections into a facial scar safe?
According to research reviews, injections can be more effective than other non-surgical methods, but steroids can thin the skin and cause vascular "spider veins." Therefore, the dose, number, and intervals are selected by a doctor.
Can a scar be removed with a laser?
A laser can make a scar flatter, softer, and less noticeable, but it does not completely remove it. The result depends on the type of laser and skin.
When is surgery necessary?
When the scar tightens the skin, pulls on the eyelid or lip, or remains thick despite treatment. After surgery, silicone, injections, or laser are usually continued.
Can a scar be camouflaged while treatment is ongoing?
Yes. There are special creams and powders that are matched to the skin color so that the scar is less noticeable.
Sources
18 sources · international guidelines, systematic reviews, and NHSshowCollapse
- The Most Current Algorithms for the Treatment and Prevention of Hypertrophic Scars and Keloids: A 2020 Update of the Algorithms Published 10 Years AgoPlastic and Reconstructive Surgery, 2022doi:10.1097/PRS.0000000000008667 ↗
- Diagnosis and Treatment of Keloids and Hypertrophic Scars — Japan Scar Workshop Consensus Document 2018Burns & Trauma, 2019doi:10.1186/s41038-019-0175-y ↗
- Updated international clinical recommendations on scar management: part 2--algorithms for scar prevention and treatmentDermatologic Surgery, 2014pubmed.ncbi.nlm.nih.gov/25068544 ↗
- Updated scar management practical guidelines: non-invasive and invasive measuresJournal of Plastic, Reconstructive & Aesthetic Surgery, 2014doi:10.1016/j.bjps.2014.04.011 ↗
- Silicone gel sheeting for preventing and treating hypertrophic and keloid scarsCochrane Database of Systematic Reviews, 2013doi:10.1002/14651858.CD003826.pub3 ↗
- Treatment of traumatic hypertrophic scars and keloids: a systematic review of randomized control trialsArchives of Dermatological Research, 2023doi:10.1007/s00403-023-02535-3 ↗
- The safety and efficacy of intralesional triamcinolone acetonide for keloids and hypertrophic scars: A systematic review and meta-analysisBurns, 2021doi:10.1016/j.burns.2021.02.013 ↗
- Laser therapy for prevention and treatment of pathologic excessive scarsPlastic and Reconstructive Surgery, 2013doi:10.1097/PRS.0b013e3182a97e43 ↗
- Laser Treatment of Traumatic Scars and Contractures: 2020 International Consensus RecommendationsLasers in Surgery and Medicine, 2020doi:10.1002/lsm.23201 ↗
- Reducing Risks of Facial ScarringFacial Plastic Surgery Clinics of North America, 2023doi:10.1016/j.fsc.2023.01.003 ↗
- Improving facial scar outcomes: an evidence-based updateCurrent Opinion in Otolaryngology & Head and Neck Surgery, 2026doi:10.1097/MOO.0000000000001136 ↗
- Effectiveness of Autologous Fat Grafting in the Treatment of Scars: A Systematic Review and Meta-AnalysisAesthetic Plastic Surgery, 2024doi:10.1007/s00266-024-04131-w ↗
- Management of Facial ScarsFacial Plastic Surgery, 2019doi:10.1055/s-0039-3401642 ↗
- Epidemiology and impact of scarring after burn injury: a systematic review of the literatureJournal of Burn Care & Research, 2012doi:10.1097/BCR.0b013e3182374452 ↗
- Correction of cicatricial deformation of the frontal area: surgical methods and results of own researchHospital surgery, 2025doi:10.11603/2414-4533.2025.2.15396 ↗
- ScarsNHS, 2023nhs.uk/conditions/scars ↗
- Cuts and grazesNHS, 2026nhs.uk/conditions/cuts-and-grazes ↗
- Burns and scaldsNHS, 2026nhs.uk/conditions/burns-and-scalds ↗
The figures on the page are from these sources.
Scar on the face
Thickening or itching?
Send a close-up photo of the scar and the face front and side. The doctor will say what can be done and where to start.