An overgrowth of scar tissue that extends beyond the original wound site
What are Keloids?
Keloids are a type of raised scar that occurs when the body overproduces collagen during the healing process after a skin injury. Unlike regular scars, keloids grow beyond the boundaries of the original wound and do not regress over time. They can appear after cuts, burns, acne, piercings, surgical incisions, or even minor skin trauma.
Keloids are benign (non-cancerous) but can be cosmetically concerning or physically uncomfortable, depending on their size and location.
What causes Keloids?
Keloids are caused by an excessive healing response of the skin. When the skin is injured, fibroblast cells work to repair it by producing collagen. In some individuals, this process goes into overdrive, forming thick, rubbery scar tissue that extends beyond the wound.
Contributing factors include:
- Genetic predisposition
- Skin trauma or injury
- Infection or inflammation at the wound site
- Tension or stretching of the wound during healing
Who is at risk?
- People with darker skin tones, particularly of African, Hispanic, or Asian descent
- Individuals with a family history of keloids
- People between the ages of 10 and 30
- Those with piercings, tattoos, or repeated trauma to the skin
- Individuals prone to acne scars or surgical scars
What are the symptoms of Keloids?
- Raised, thickened scar that is shiny and firm
- Growth beyond the original wound margins
- Pink, red, purple, or dark brown coloration (varies with skin tone)
- Itching, tenderness, or burning sensation
- In some cases, pain or restriction of movement (especially on joints)
- May continue to grow for weeks or months after the injury
How are Keloids diagnosed?
Keloids are diagnosed clinically based on:
- Physical examination of the scar’s appearance
- Patient history of injury, surgery, or acne
- Differentiation from other skin growths or hypertrophic scars
- Biopsy (rarely needed) to rule out other conditions if the diagnosis is uncertain
How are Keloids treated?
Treatment can be challenging, and no single approach works for everyone. Options include:
- Corticosteroid injections – reduce inflammation and size
- Silicone gel sheets or dressings – flatten and soften the scar over time
- Cryotherapy – freezing the keloid with liquid nitrogen
- Laser therapy – reduces redness and thickness
- Surgical removal – often combined with other therapies to reduce recurrence
- Radiation therapy – used post-surgery in resistant cases
- Pressure garments – often used after burns or surgery to prevent keloid formation
Note: Even with treatment, keloids have a high recurrence rate, especially after surgical removal.
What is the prognosis for Keloids?
- Keloids are not dangerous but can cause discomfort or emotional distress
- Many stabilize over time but may remain permanently enlarged
- Early treatment improves outcomes
- Patients should be counseled on the likelihood of recurrence
Can Keloids be prevented?
Prevention is key, especially for individuals at high risk:
- Avoid unnecessary skin trauma (e.g., cosmetic piercings or tattoos)
- Use pressure earrings or silicone sheets after ear piercings
- Apply topical silicone or scar-reducing products after surgery or injury
- Inform surgeons ahead of any planned operations about keloid history
- Treat acne and other skin conditions early to minimize scarring