Scars always occur when tissues have been significantly damaged and repaired. Scars produce changes that disturb the physical architecture of normal skin or other tissue. Scars can occur after physical trauma or as part of a disease process. Poorly controlled wound healing can result in thick, unsightly scars that cause symptoms. There is a genetic predisposition in some people to produce thicker, itchy, enlarging scars called keloids. Scarring in areas of increased skin tension or movement tend to be unsightly. When wounds are produced surgically, physicians utilize techniques to minimize scarring.