Black History Month starts on 1 October. Why melanin-rich skin reacts differently to peels, lasers and needles, and what a safe consultation covers.

Keloid and hypertrophic scars are driven by disordered wound healing and have a high risk of recurrence. This evidence-weighted meta-analysis reviews current treatments, including silicone therapy, pressure therapy, intralesional injectables, cryotherapy, laser devices, and surgery with radiotherapy. The evidence shows combination therapies outperform single treatments, with specialist escalation offering the lowest recurrence, in line with NHS guidance.