Scars are a natural part of the healing process, but not all scars heal the same way. While some scars gradually flatten and fade over time, others may become raised, thickened, firm, or darker in color. These types of scars are commonly referred to as hypertrophic scars or keloids and develop when the body produces excess collagen during healing (Hsu et al., 2017).

Raised scars can form after surgery, burns, injuries, acne, or other skin trauma. Understanding why they develop may help support healthier healing outcomes and encourage earlier scar management.

What Causes a Scar to Become Raised?

When skin is injured, the body begins repairing damaged tissue by producing collagen, a structural protein that helps close and strengthen the wound. However, in some cases, the body continues producing collagen beyond what is necessary, leading to excessive scar tissue formation (Bleasdale et al., 2015).

This excess collagen buildup can cause scars to become:

• Thick

• Elevated above surrounding skin

• Firm or rigid

• Red or discolored

• Itchy or uncomfortable

Inflammation also plays a major role in abnormal scar formation. Prolonged inflammation may overstimulate fibroblasts — the cells responsible for collagen production — causing scar tissue to continue building even after the wound has closed (O’Brien & Jones, 2013).

Hypertrophic Scars vs. Keloids

Although both are raised scars, hypertrophic scars and keloids are different types of abnormal scar tissue.

Hypertrophic Scars

Hypertrophic scars remain within the borders of the original wound. They are commonly associated with:

• Surgical incisions

• Burns

• Traumatic injuries

• Areas of high skin tension

These scars may gradually improve over time but can remain raised for months or even years (Hsu et al., 2017).

Keloids

Keloids extend beyond the boundaries of the original injury and continue growing into surrounding skin. Keloids are more likely to persist long term and are often more difficult to manage (McCarty et al., 2010).

Factors That Increase the Risk of Raised Scars

Several factors may increase the likelihood of developing thickened or raised scars.

Skin Tension

Areas of the body exposed to frequent movement or stretching are more prone to widened or thickened scars. This includes:

• Chest

• Shoulders

• Abdomen

• Joints

• Upper back

Mechanical tension places stress on healing tissue, which may stimulate additional collagen production during wound repair (Bleasdale et al., 2015).

Delayed Healing

The longer a wound takes to heal, the greater the risk of excessive scar formation. Delayed healing may prolong inflammation and increase collagen activity within the skin (Hsu et al., 2017).

Genetics

Some individuals are genetically predisposed to hypertrophic scars or keloids. A family or personal history of abnormal scarring may increase risk (McCarty et al., 2010).

Infection or Irritation

Infection, repeated friction, or irritation to healing skin can disrupt the repair process and contribute to abnormal scar development (O’Brien & Jones, 2013).

Sun Exposure

UV exposure during healing may worsen scar discoloration and prolong inflammation, making scars appear darker and more noticeable over time (Hsu et al., 2017).

Why Silicone Is Commonly Recommended for Raised Scars

Silicone therapy is widely considered one of the leading non-invasive approaches for managing hypertrophic scars and keloids (O’Brien & Jones, 2013).

Research suggests silicone works by creating a breathable, semi-occlusive barrier over the scar that helps:

• Maintain hydration

• Reduce transepidermal water loss (TEWL)

• Support a balanced healing environment

• Help regulate collagen production (Bleasdale et al., 2015)

Consistent silicone use has been associated with improvements in scar thickness, texture, redness, and overall appearance (Hsu et al., 2017).

Silicone Scar Care Options from Rejûvaskin

Rejûvaskin offers silicone-based scar care products designed to help support smoother, flatter, and softer-looking scars.

Scar FX Silicone Sheets

Scar FX Silicone Sheets are made with 100% medical-grade silicone and are designed to help soften and flatten raised scars while protecting healing skin from friction and irritation. Silicone sheeting is commonly recommended for:

• Surgical scars

• Burn scars

• Hypertrophic scars

• Keloid-prone skin

By maintaining hydration within the scar tissue, silicone sheets help create an environment that supports healthier scar maturation (O’Brien & Jones, 2013).

Scar Esthetique Silicone Scar Cream

Scar Esthetique combines silicone with antioxidants, polypeptides, and botanical ingredients designed to support scar texture and discoloration. It is often used for:

• Older scars

• Discolored scars

• Uneven scar texture

• Long-term scar management routines

Its formula helps support overall scar appearance while keeping skin moisturized and conditioned.

When Should You Start Scar Care?

Early scar management is often associated with better cosmetic outcomes. Many healthcare professionals recommend beginning silicone therapy once the wound is fully closed and no longer open or scabbed (O’Brien & Jones, 2013).

Scar remodeling can continue for up to a year or longer, meaning consistent scar care may still provide visible improvements even months after an injury or surgery (Hsu et al., 2017).

Raised or thickened scars develop when the body’s healing response becomes overactive, leading to excessive collagen production and prolonged inflammation. Factors like skin tension, delayed healing, genetics, irritation, and sun exposure can all influence how a scar heals.

While abnormal scarring cannot always be prevented, early and consistent scar care — especially with silicone-based treatments — may help support flatter, softer, and less noticeable scars over time (Bleasdale et al., 2015).

Works Cited

Bleasdale, B., Finnegan, S., Murray, K., Kelly, S., & Percival, S. L. (2015). The use of silicone adhesives for scar reduction. Advances in Wound Care, 4(7), 422–430. https://pmc.ncbi.nlm.nih.gov/articles/PMC4486716/

Hsu, K. C., Luan, C. W., Tsai, Y. W., & Lin, Y. T. (2017). Review of silicone gel sheeting and silicone gel for the prevention of hypertrophic scars and keloids. Aesthetic Plastic Surgery, 41(5), 1178–1186. https://pubmed.ncbi.nlm.nih.gov/28570253/

McCarty, M., et al. (2010). An evaluation of evidence regarding application of silicone gel sheeting for the management of hypertrophic scars and keloids. Journal of Clinical and Aesthetic Dermatology, 3(1), 39–43. https://pmc.ncbi.nlm.nih.gov/articles/PMC2989813/

O’Brien, L., & Jones, D. J. (2013). Silicone gel sheeting for preventing and treating hypertrophic and keloid scars. Cochrane Database of Systematic Reviews, (9). https://www.cochrane.org/evidence/CD003826_silicone-gel-sheeting-preventing-development-hypertrophic-and-keloid-scars-and-treating-existing