Background: This article reviews current knowledge on the pathogenesis and process of wound healing, highlighting the differences between scar types. It discusses the pathogenesis and characteristics of hypertrophic scars and keloids, along with therapeutic approaches, including adjuvant, targeted, and non-targeted therapies. Psychological aspects and their impact on patients’ lives are also addressed. Methods: A comprehensive literature search was conducted in the PubMed and Cochrane databases to identify articles on scar pathogenesis and treatment methods, published between 2007 and 2025. Results: The wound healing process is complex and multistage, involving inflammation, proliferation, angiogenesis, and extracellular matrix remodelling. Various cells (including fibroblasts and immune cells) and growth factors such as TGF-β, PDGF, and VEGF, participate in this process. Disruptions to healing can lead to the formation of pathological scars, including keloids and hypertrophic scars. Despite advances in therapeutic approaches, the mechanisms underlying their formation are not fully understood. The best clinical outcomes are achieved through combination therapy. Conclusion: A wound represents a disruption of skin integrity, and its healing is a dynamic, multistage process encompassing inflammation, proliferation, cell migration, angiogenesis, remodelling, and extracellular matrix synthesis. Healing engages immune cells, connective tissue, epithelial cells, inflammatory mediators, and the vascular system. Abnormalities can lead to pathological scarring. The mechanisms of scar formation remain unclear, which complicates effective management. Hypertrophic scars and keloids, often occurring in high-tension areas, are particularly challenging. Scars cannot be completely eliminated, and no single therapy is universally effective; combined methods yield the best results.