Consultation for scar redness, thickening, itching, pain, or contracture in Motomachi, Kobe
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Even after the wound has healed, redness and swelling persist, itching and pain, and tightness when moving. There are treatment options for these scars.
We will check the type and symptoms of the scar, and treat it according to the condition in our plastic surgery clinic, from conservative treatments such as patches and injections to surgery.
Plastic surgery Specialist
Writing/Medical confirmationDirector Nie Ie
Board-certified plastic surgeon, Japan Society of Plastic and Reconstructive Surgery
If the following symptoms persist even after the wound has closed, please consult a plastic surgeon.
Redness persists for a long time
The scar has become hard and raised.
Itching and pain
Spreads outward from the original wound
Joints and neck become tight and difficult to move.
Scars got bigger after piercing or surgery
Even if it looks like a keloid, it may be hiding another disease such as an infection or a skin tumor. Please do not scratch or strongly stimulate the area on your own, and consult a doctor.
TYPES OF SCARS
Differences between scars, hypertrophic scars, and keloids
Although scars may look the same, treatment differs depending on how they spread, symptoms, and how long it has been since they appeared.
Type
Main conditions
How to spread
Concept of treatment
Mature scar
The redness has subsided and the scar has become whitish and flat.
Original wound area
Treatments to further improve appearance may be self-pay.
Hypertrophic scar
It may become red, hard, and raised, and may be accompanied by itching and pain.
Generally within the original wound
Mainly conservative treatment, considering surgery depending on progress and tingling
keloid
Redness, swelling, itching, and pain may persist.
Can spread beyond the original wound
Be careful of recurrence and combine multiple treatments
Scar contracture
The scar shrinks, causing tightness and difficulty in moving.
Affects function in joints, neck, mouth area, etc.
In addition to conservative treatment, consider plastic surgery if necessary
01
Wounds heal
Even after the skin closes, tissue repair continues inside the wound.
02
Redness/hardness
Redness and hardness may be noticeable temporarily during the healing process.
03
Check progress
If the swelling or symptoms are strong, start treatment early.
DOCTOR'S GUIDE
How plastic surgeons assess scars
When examining a scar, we do not diagnose a keloid based on appearance alone.
We will check the time since the wound was formed, its position relative to the original wound, redness, hardness, thickness, itching, pain, and difficulty in moving the joint. The goal of treatment is not to eliminate the scar completely, but to calm the inflammation, reduce symptoms and functional impairment, and make it as unnoticeable as possible.
Ie Nie, MD
POINT 01
When did the scar change, and how?
Hypertrophic scars are caused by continued inflammation even after the wound has closed, and redness and swelling may become noticeable after several weeks. Check the length of time since injury, surgery, or piercing, and the speed of change.[1]
POINT 02
Is it beyond the original wound?
Hypertrophic scars generally grow within the area of the original scar, and keloids may extend outside the scar. However, there are also transitional lesions, so it is necessary to make a judgment that takes into account the course of the disease.
POINT 03
Symptoms and impact on life
In addition to checking for itching, pain, and drainage, we also check the range of motion around the neck, joints, and mouth and the effect on daily activities. Scar contracture with functional impairment is an important reason to consider surgery.
WHY SCARS CHANGE
Why are scars red, hard, and raised?
Even after the skin closes, inflammation, collagen production, and tissue remodeling continue internally. If the inflammation lasts for a long time, or if pulling force continues to be applied to the wound from the chest, shoulders, joints, etc., redness, hardness, and thickness tend to remain.
Inflammatory phaseRedness and swelling appear
Proliferative phaseCreates tissue to close wounds
Maturation phaseHardness and color change over time
Treatment is planned according to "stage, symptoms, function, and risk of recurrence"
01
Early/prevention
Reduce tension and friction on the wound and protect it with tape or silicone.
02
Inflammation is active
Steroid patches, injections, and oral medication can suppress redness, swelling, itching, and pain.
03
Difficult with conservative treatment
Excision and reconstructive techniques may be considered based on the thickness, drainage, severe symptoms, and scar contracture.
04
Post-operative/long-term management
Reduce the force at the suture, combine fixation and drug therapy, and monitor for recurrence.
CONSERVATIVE CARE
Conservative treatment of scars and keloids
Nonsurgical treatment may begin to calm inflammation, swelling, itching, and pain.
01
Oral medicine
This treatment uses oral medications such as tranilast to suppress subjective symptoms such as itching.
02
Steroid tape and topical treatment
Continue to use steroid tape to reduce redness and swelling. Depending on the area, we may combine silicone or tape fixation.
03
Steroid injection
A drug is injected into the lesion to suppress redness, swelling, itching, and pain. Injections are spaced according to the clinical response.
04
Compression/fixation
Reduces the friction and stretching force applied to the scar and keeps it at rest. Special pressure devices may be used for areas such as the ears.
SURGERY & AFTERCARE
Scar/keloid surgery and postoperative care
For contracture or large raised scars, consider surgery
Surgery is considered when it is difficult to move due to scar contracture, when there is a large change in shape in a noticeable area, or when it is difficult to improve with conservative treatment alone.
Using techniques such as Z-plasty, W-plasty, and local flap surgery, the force applied to the scar is dispersed by changing the direction of the wound and suturing it in a zigzag pattern.
In addition to excision, the key to preventing recurrence of keloids is to combine postoperative steroid treatment, compression/fixation, and radiotherapy depending on the lesion and location.[1] The suitability of radiotherapy is determined on an individual basis by a medical institution that can handle the treatment, taking into account factors such as age, location, and size of the lesion.
Linear twitch→Distribute force by changing direction
01
Continue fixation even after suture removal
Protect the scar with silicone, surgical tape, steroid tape, etc.
02
Monitor for early signs of recurrence
Check regularly for changes in redness, hardness, itching, pain, and renewed elevation.
03
Look at the progress over the long term
Keloids may recur after a delay. Guidelines indicate at least 2 years of follow-up after treatment, with longer-term confirmation required for some combination therapies.[1]
Treatment risks and precautions
Oral medicines may cause stomach discomfort, liver dysfunction, etc., topical steroids and tape may cause rash, thinning of the skin, etc., and injections may cause pain, skin atrophy or depressions, changes in color, etc. Surgery can cause bleeding, infection, pain, swelling, scarring, and recurrence of keloids. Details will be explained to you before treatment.
CASE REPORTS
Keloid surgery cases
This is the early progress one week after the ear keloid that occurred after the piercing was removed. One week after surgery is too early to assess the final result; after that, we will continue to prevent recurrence and continue long-term observation.
The progress and treatment details of each case vary from person to person. We do not guarantee the same results. As side effects of postoperative adjuvant therapy, steroids may cause skin atrophy and pigment changes, and pressure may cause skin disorders.
INSURANCE & PRIVATE CARE
Treatment under Japan's public health insurance and self-pay treatment for scars and keloids
INSURANCE
Treatment under Japan's public health insurance
If you experience symptoms such as redness, swelling, itching, pain, or tingling, and it is determined that treatment is necessary, treatments such as medicated tape, injections, and surgery may be covered by insurance.
PRIVATE CARE
Self-pay treatment
Treatments aimed at treating flat, white, mature scars or improving the appearance may be self-pay. Consider ADVATx for redness, and TriFill Pro for dents and hardness.
Whether insurance is applicable or not and the amount you will pay out-of-pocket will vary depending on the diagnosis, treatment details, and insurance coverage ratio. We will inform you after the examination.
OUR APPROACH
Treating scars from both functional and cosmetic aspects
01
Distinguishing the types of scars
Check the period since the wound was formed, its position relative to the original wound, redness, hardness, swelling, and any symptoms you may be aware of.
02
Discuss options from conservative treatment to surgery
We will summarize the strength of the symptoms and their impact on daily life, and explain treatment methods, including the frequency and burden of clinic visits.
03
Check the progress after treatment
Keloids and hypertrophic scars may become red or raised again even after treatment. We will monitor your progress, including post-operative immobilization and regular check-ups.
FAQ
Frequently asked questions about scars and keloids
Can I consult with you about my old scars?
You can consult with us. We will check for redness, swelling, itching, pain, strain, and width of the wound, and recommend the treatment that suits your current condition. There are limits to the treatment of mature white scars under insurance, so we may suggest self-pay treatment.
What is the difference between hypertrophic scar and keloid?
Hypertrophic scars generally grow within the area of the original scar and may subside over time. Keloids can spread beyond the original wound and are more likely to recur. It is difficult to judge based on appearance alone, so a medical examination is required.
Can keloids be treated with surgery?
Keloids may recur if they are removed only by excision. When performing surgery, it is important to prevent recurrence by combining sutures to reduce the force applied to the wound and post-operative care such as tape and compression.
Is scar/keloid treatment covered by insurance?
Depending on the symptoms and treatment details, treatment may be covered by insurance. Treatments such as laser treatment aimed at further improving the appearance may be an self-pay treatment. After your consultation, we will explain the treatment method and cost classification.
Can I consult with you about lumps in my ears after piercing?
You can consult with us. The auricle and earlobe are areas where keloids can occur. We will check the size, redness, pain, and progress of growth to consider treatment options.
CONSULTATION
Please consult us if you are concerned about changes in a scar
It will take some time for the scar to subside, but if strong redness, swelling, itching, pain, or contracture persists, medical assessment may be appropriate. If you are unsure about where to go, you can also contact us by phone.
References reviewed: August 5, 2026. This text is general medical information, and the appropriateness of diagnosis and treatment will depend on the findings of the examination.
Minato Motomachi Beauty and Plastic Surgery Clinic Director
Ie Nie, MD
Board-certified plastic surgeon, Japan Society of Plastic and Reconstructive Surgery
As a plastic surgeon, we treat trauma, burns, skin tumors, scars, scar contracture, etc. We will explain the treatment strategy, not only regarding the appearance but also including pain, itching, difficulty in moving, and the risk of recurrence.
