A genetic predisposition to keloid formation can predispose one to keloids. Also, infections in the wound, hair ingrowth, foreign materials including sutures, can all lead to unfavorable scarring. Sometimes the exact cause is unknown.
There are surgical options such as excision and reconstruction of the scar. Nonsurgical options include injection of steroids (very common) and injection of antineoplastic agents (uncommon). Finally, external scar treatments such as silicone pressure patches are also employed.