Approximately 65% of People Troubled by Raised Scars Were Unaware Treatment Was Available, Revealing Three Misconceptions in Keloid and Hypertrophic Scar Awareness Survey

【Conclusion】Key Findings of This Survey

In conclusion, raised scars result from excessive collagen production during the wound healing process. While keloids rarely heal naturally, appropriate treatment can lead to improvement. The key difference between keloids and hypertrophic scars is that keloids continue to grow beyond the original wound site, whereas hypertrophic scars remain confined to the wound area and tend to improve over time.

・64.7% of people troubled by raised scars responded, "I didn't know treatment was possible."

・Only 18.3% correctly understood the difference between keloids and hypertrophic scars

・78.6% of those who received treatment felt, "I wish I had sought treatment earlier."

Terminology Explanation

What is a Keloid?

A keloid is a condition in which, during the healing process, fibroblasts over-proliferate and abnormally accumulate collagen, forming a red, raised scar tissue that extends beyond the original wound. It rarely resolves naturally and often causes itching and pain. Genetic factors and individual constitution play a role, and keloids commonly occur on the chest, shoulders, earlobes, and lower abdomen.

What is a Hypertrophic Scar?

A hypertrophic scar is a condition where excessive collagen production during wound healing causes the scar to become red and raised. Unlike keloids, hypertrophic scars remain within the original wound boundaries and tend to flatten and soften naturally over several months to years. They commonly develop in areas under tension, such as joints.

What is Steroid Local Injection Therapy?

Steroid local injection therapy involves directly injecting corticosteroids, such as triamcinolone, into keloids or hypertrophic scars. It suppresses collagen synthesis and helps soften and reduce scar tissue. This treatment is recommended as a first-line option in the Japanese Dermatological Association guidelines.

Comparison Between Keloids and Hypertrophic Scars

Comparison Item

Keloid

Hypertrophic Scar

Extends beyond original wound?

Yes, continues to spread

Remains within wound area

Natural course

Rarely improves naturally

Tends to improve over months to years

Common sites

Chest, shoulders, earlobes, lower abdomen

Areas under tension, such as joints

Itching and pain

Often severe

Relatively mild

Involvement of constitution

Strong (genetic factors involved)

Relatively weak

Need for treatment

Active treatment required

Observation may be an option

※Clinical observations based on over 30,000 dermatological surgeries supervised by our physicians. Individual symptoms may vary.

IC Clinic (Shinjuku, Shibuya, Ueno, Ikebukuro, Tokyo, and Omiya branches), operated by the medical corporation Tekiketsukai, conducted an awareness survey on raised scars (keloids and hypertrophic scars). Under the supervision of Dr. Kozou Takakura, who has over 30,000 surgical experiences in dermatology and skin surgery, the clinic provides outpatient surgeries and various scar treatments. This survey aims to clarify public awareness and attitudes toward scar treatment and to provide accurate information.

Survey Background

Keloids and hypertrophic scars that form after trauma or surgery can impair daily life not only cosmetically but also due to itching, pain, and restricted movement in joint areas. However, many people accept scars as unavoidable or fail to understand the difference between keloids and hypertrophic scars, often missing the optimal timing for treatment. To address this, our clinic conducted this survey to promote accurate knowledge and emphasize the importance of early intervention.

Survey Overview

Target: Men and women aged 20–60 across Japan who have experienced or currently suffer from raised scars (keloids or hypertrophic scars)

Survey Period: June 22 to July 1, 2026

Method: Online survey

Number of Respondents: 300

Survey Results: Approximately 65% Were Unaware Raised Scars Could Be Treated

Question: Were you aware that raised scars (keloids or hypertrophic scars) can be treated at medical institutions?

Over 60% were unaware that raised scars can be medically treated. This reveals a widespread belief that scars are unavoidable and a lack of awareness about available treatment options.

Only 18.3% Correctly Understood the Difference Between Keloids and Hypertrophic Scars

Question: Do you know the difference between keloids and hypertrophic scars?

More than half perceive keloids and hypertrophic scars as the same condition, and fewer than 20% correctly understand the difference. Since treatment approaches and prognosis differ, this highlights the importance of accurate diagnosis and patient education.

"Cosmetic concerns" were the top issue at 42.0%, followed by "itching and pain" at 31.7%

Question: What bothers you most about raised scars?

While cosmetic concerns were the most common, over 30% reported physical discomfort such as itching and pain. This shows that keloids significantly impact quality of life (QOL), not just appearance.

"Doing nothing in particular" was the most common response at 38.7%, while only 26.3% used over-the-counter products

Question: What have you done so far to address raised scars? (Multiple answers allowed; select the most applicable)

About 40% reported taking no action. Fewer than 20% visited a medical institution, revealing that most people are not receiving appropriate treatment.

78.6% of Those Who Received Treatment Felt "I Should Have Sought Treatment Sooner"

Question: For those who received treatment for raised scars, how do you feel about the timing of your treatment?

Approximately 80% of treated individuals regret not seeking care earlier, suggesting that early treatment is more effective. Especially for keloids, treatment becomes more difficult as the condition progresses, reaffirming the importance of early intervention.

Survey Summary

This survey revealed low awareness of raised scars (keloids and hypertrophic scars). About 65% were unaware treatment was possible, and over half did not understand the difference between keloids and hypertrophic scars. Additionally, about 40% took no action, and fewer than 20% visited a medical institution. On the other hand, about 80% of those who received treatment regretted not seeking care sooner, highlighting the urgent need for early intervention and public education. Raised scars not only affect appearance but also impact QOL through itching, pain, and daily life limitations. Appropriate treatment at the right time can lead to symptom improvement.

Physician Comment | Dr. Kozou Takakura, IC Clinic

Based on my experience supervising over 30,000 dermatological surgeries, I emphasize that keloids and hypertrophic scars are not "scars to be accepted" but "conditions that can improve with treatment." Many patients experience symptom relief when appropriate treatment begins early.

The mechanism behind raised scars involves fibroblasts over-activating during healing and producing excess collagen. Normally, excess collagen breaks down as the wound heals, resulting in a flat scar. However, when this regulatory function fails, the scar remains red and raised.

Keloids and hypertrophic scars are often confused, but distinguishing them is crucial for determining treatment. Keloids extend beyond the original wound