Keloidal scars (KS) and hypertrophic scars (HTS) cause cosmetic problems, physical impairment, and psychological and social problems. KS and HTS are abnormal fibrous wound healing in response to trauma, surgery, inflammation, and burns due to a lack of regeneration regulation control mechanism of wound healing. They occur in 30–90% of patients. They are both raised, firm scars formed from excessive fibrinogen production and collagen during healing. Pruritus, pain, and pressure are seen in KS and HTS, but the main concern is aesthetic disfigurement. Although they manifest the same inflammatory fibroproliferative process, there are differences between HTS and KS. HTS is contained within the injury site and may regress over time, whereas KS spreads beyond the borders of the initial injury and does not regress. On histological examination, HTS tends to have hypertrophic collagen in a wavy pattern, whereas KS has no distinct pattern of collagen; thick and uniformly stained collagen fibers are called keloidal or hyalinized collagen. Generally, HTS occurs with injury within 4–8 weeks and has rapid growth for up to 6 months, then regresses, eventually leading to a flat scar with no symptoms. HTS scar formation is rare after the excision of the original lesion. KS tends to recur following excision. KS appears as firm, mildly tender, bosselated tumors with a shiny surface and sometimes telangiectasia with focal areas of ulceration. The borders of the tumor are well demarcated but irregular in outline. HTS has a similar appearance but is usually linear if following a surgical scar or papular or nodular, following inflammatory and ulcerating lesions.