Background: Keloid and hypertrophic scars develop most frequently in wounds with high skin tension and especially on the upper truncus. Both are characterized by an excessive dysfunctional collagen metabolism.
Material and methods: The article presents data from research in current literature and discuss the treatment of keloid and hypertrophic scars.
Results and interpretation: Patients that are undergoing elective surgery should be handled with surgical techniques that reduce wound closing tension. Patients who are at high-risk or show excessive scar development should follow standard treatment. First-line therapy is silicone sheeting and/or pressure. In case of minimal response, steroid injections should be started after two months. The patient must be re-evaluated for a surgical approach combined with conservative treatment if the result is unsatisfactory after 12 months.