Scar Classification1

Mature

Light-colored and flat

Immature

Red, sometimes itchy and painful, slightly elevated. Many will mature to become flat and assume pigmentation similar to the surrounding skin, although they can be paler or slightly darker.

Widespread stretched

Appear when the fine lines of surgical scars gradually become stretched and widened. Typically flat, pale, soft, symptomless scars often seen after knee or shoulder surgery. Stretch marks after pregnancy are variants of widespread scars. No elevation, thickening or nodularity which distinguishes them from hypertrophic scars.

Contractures

Scars that cross joints or skin creases at right angles are prone to develop shortening or contracture. Occur when the scar is not fully matured. Often tend to be hypertrophic, and are typically disabling and dysfunctional. Common after burn injuries.

Linear hypertrophic

Red, raised and sometimes itchy. Confined to the border of the original surgery or trauma. Develops within weeks after surgery. May increase rapidly in size for three to six months and then, after a static phase, begin to regress. Mature to have an elevated, slightly rope-like appearance with increased width. Full maturation can take up to two years.

Widespread hypertrophic

Common after a burn. A widespread red, raised and sometimes itchy scar that remains within the borders of the original burn.

Minor keloid

A focally raised, itchy scar that extends over normal tissue. May develop up to several years after injury and does not regress without treatment. Surgical excision is often followed by recurrence.

Major keloid

A large, raised scar which may be painful or pruritic. Extends over normal tissue and can continue to spread over many years.

1. Mustoe TA et al. Plast Reconstr Surg 2002;110:560–571