Keloid & Hypertrophic scars are:

• Scars that remain red and beefy after six months
• Healing is stalled or arrested
• Top layer or Stratum corneum looks closed but is compromised and open
• Silicone sheeting is the recommended firstline of defense

How lesions become chronic scars:

• a compromised startum corneum, or top layer of skin
• epi-genitic familial background from tropical areas 
• high skin tension along the wound edges
• inverted calcium gradient in epidermis
• over calcification in dermis

Strategy for healing chronic scars is:

• Stratum corneum and barrier repair;
  • correcting the calcium gradient in epidermis by drawing calcium to skin surface
  • supply cholesterol, ceramides to rebuild stratum corneum
  • induce CD 36 release 
• • The induction of Collegenase to remove old collegan; collegen bundles form do to prolonged tension along the skin edges soften the old bundled collegan 
• • induce Collagenase the enzyme that breaks up and desovles collagen