Keloids: Type, Prevention and Treatment

Keloid of the upper hand

What is a keloid?

Keloids can be considered to be “scars that don’t know when to stop.” A keloid, sometimes referred to as a keloid scar, is a tough heaped-up scar that rises quite abruptly above the rest of the skin. It usually has a smooth top and a pink or purple color. Keloids are irregularly shaped and tend to enlarge progressively. Unlike scars, keloids do not regress over time.

Symptoms that Associated with Keloids?

Keloids occur from the overgrowth of scar tissue. Symptoms occur at a site of previous skin injury.

The symptoms of keloids can include:

  • a localized area that is flesh-colored, pink, or red in color
  • a lumpy or ridged area of skin that’s usually raised
  • an area that continues to grow larger with scar tissue over time
  • an itchy patch of skin

Keloid scars tend to be larger than the original wound itself. They may take weeks or months to develop fully.

While keloid scars may be itchy, they’re usually not harmful to your health. You may experience discomfort, tenderness, or possible irritation from your clothing or other forms of friction. In rare instances, you may experience keloid scarring on a significant amount of your body. When this occurs, the hardened, tight scar tissue may restrict your movements.

Keloids are often more of a cosmetic concern than a health one. You may feel self-conscious if the keloid is very large or in a highly visible location, such as an earlobe or on the face. Sun exposure or tanning may discolor the scar tissue, making it slightly darker than your surrounding skin. This can make the keloid stand out even more than it already does. Keep the scar covered when you’re in the sun to prevent discoloration.

Causes of Keloids

Keloids can form after skin injuries from:

  • Acne
  • Burns
  • Chickenpox
  • Ear piercing
  • Minor scratches
  • Cuts from surgery or trauma
  • Vaccination sites

Keloids are most common in people ages 10 to 20, and in African Americans, Asians, and Hispanics. Keloids often run in families. Sometimes a person may not know what injury caused a keloid to form.

Who gets keloid scars?

Keloid scars can affect anyone, but some people are more likely than others to get them. “People with dark skin get keloids much more easily than people with fairer skin, and it’s common in people with black skin,” says Lawson. It’s thought that keloid scarring may run in families.

Keloid scars can develop after even a very minor injury. “Burns, acne scars and wounds that get infected are particularly likely to form keloids,” says Lawson.

“You’re at higher risk of getting a keloid scar if you have had one before.”

Can I reduce the risk?

You can’t stop a keloid happening, but you can avoid any deliberate cuts or breaks in the skin, such as tattoos or piercings, including on the ear lobes.

What is the treatment for keloid scars?

There are several treatments available, but none have been shown to be more effective than others. Treatment can be difficult and isn’t always successful. Treatments that may help flatten a keloid include:

  • steroid injections
  • applying steroid-impregnated tape to the area for 12 hours a day
  • applying silicone gel sheeting to the area for several months, although a review of studies found that it is unclear whether this works or not to prevent or treat keloid scars

Other options are:

  • freezing early keloids with liquid nitrogen to stop them from growing
  • laser treatment to lessen redness (this won’t make the scar any smaller)
  • surgery to remove the keloid (however, the keloid can grow back and may be larger than before)

If you’re bothered by a keloid scar and want help, see your GP.

Prevention of Keloid

When you are in the sun:

  • Cover a keloid that is forming with a patch or Band-Aid.
  • Use sunblock.

Continue to follow these steps for at least 6 months after injury or surgery for an adult, or up to 18 months for a child.

Imiquimod cream can be used to prevent keloids from forming after surgery, or from returning after they are removed.

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