About keloids

What is keloids?

A keloid scar forms from abnormal healing, and usually develops in people 10 to 20 years old.

A keloid, or keloid scar, is a kind of overgrown scar, or an overly aggressive healing response to a wound.

It's a type of thick, irregular scar that rises above the skin level and extends beyond the original wound boundaries.

Keloids most often develop in people who are between 10 and 20 years old, according to the National Institutes of Health (NIH).

They're also more commonly found in people of African American, Asian, or Hispanic descent.

What's more, some people may be genetically predisposed to getting keloids, considering that more than 50 percent of people who get keloids have family members who also have the scars, according to a 2011 report in the journal Molecular Medicine.

Hypertrophic Scar or Keloid?

Excessive scarring was first described in an Egyptian papyrus that dates back to 1700 BC.

It wasn't until the 1960s and 1970s, however, that modern physicians differentiated excessive scars into two types: hypertrophic and keloid scars.

Both types of scars rise above the skin level, but hypertrophic scars, unlike keloids, don't extend beyond the original wound.

Numerous other differences between the two types also exist.

Hypertrophic scars start to develop within two months of a traumatic injury, rapidly grow for up to 6 months, and then slowly regress over a few years until they stabilize.

They also tend to develop in body areas with high tension, including the shoulders, neck, knees, and ankles.

Keloids take several years to develop after a minor injury, sometimes form spontaneously in the mid-chest without a preceding injury, last for many years, and don't spontaneously regress.

They tend to form on the chest, shoulders, earlobes, upper arms, and cheeks.

Additionally, keloids often recur after being surgically removed, which rarely happens with hypertrophic scars.

What are the symptoms for keloids?

Scarring that is thick and uneven symptom was found in the keloids condition

Early treatment can help minimize growth of a keloid. Talk with a doctor soon after you notice a keloid. If you want to treat one that you've had for a while, talk with a doctor who specializes in skin conditions (dermatologist).

What are the causes for keloids?

Experts don't completely understand what causes keloid scars. But most agree it's likely a dysfunction of the wound-healing process. Collagen — a protein found throughout the body — is useful to wound healing, but when the body produces too much, keloids can form.

Keloid growth might be triggered by any sort of skin injury — an insect bite, acne, an injection, body piercing, burns, hair removal, and even minor scratches and bumps. Sometimes keloids form for no obvious reason.

Keloids aren't contagious or cancerous.

A keloid is different from a hypertrophic scar. A hypertrophic scar stays within the bounds of the original wound and can fade over time without treatment.

What are the treatments for keloids?

Keloid scar, before and after treatment Open pop-up dialog box Close Keloid scar, before and after treatment Keloid scar, before and after treatment

Treatment can remove a keloid scar, here under the child's right nostril. But even after successful treatment, keloids might return later.

Keloid scar treatments include the following. One or a combination of approaches might be best for your situation. Even after successful flattening or removal, keloids can grow back, sometimes bigger than before. Or you may develop new ones.

  • Wound care. For newer keloids, the first treatment option might be compression dressings made from stretchy fabric or other materials. This method is also used after surgery to remove keloids. The goal is to reduce or prevent a scar by putting pressure on the wound as it heals. Such dressings need to be worn for 12 to 24 hours a day for 4 to 6 months to be effective. This method can be very uncomfortable.
  • Corticosteroid cream. Applying a prescription strength corticosteroid cream can help ease itchiness.
  • Injected medicine. If you have a smaller keloid, your doctor might try reducing its thickness by injecting it with cortisone or other steroids. You'll likely need monthly injections for up to six months before seeing the scar flatten. Possible side effects of corticosteroid injections are skin thinning, spider veins and a permanent change in skin color (hypopigmentation or hyperpigmentation).
  • Freezing the scar. Small keloids might be reduced or removed by freezing them with liquid nitrogen (cryotherapy). Repeat treatments might be needed. Possible side effects of cryotherapy are blistering, pain and loss of skin color (hypopigmentation).
  • Laser treatment. Larger keloids can be flattened by pulsed-dye laser sessions. This method has also been useful in easing itchiness and causing keloids to fade. Pulsed-dye laser therapy is delivered over several sessions with 4 to 8 weeks between sessions. Your doctor might recommend combining laser therapy with cortisone injections. Possible side effects, which are more common in people with darker skin, include hypopigmentation or hyperpigmentation, blistering and crusting.
  • Radiation therapy. Low-level X-ray radiation alone or after surgical removal of a keloid can help shrink or minimize the scar tissue. Repeat treatments might be needed. Possible side effects of radiation therapy are skin complications and, in the long term, cancer.
  • Surgical removal. If your keloid hasn't responded to other therapies, your doctor might recommend removing it with surgery in combination with other methods. Surgery alone has a recurrence rate of 45% to 100%.

What are the risk factors for keloids?

Risk factors for keloids include:

  • Having brown or Black skin. Keloids are most common in people with brown or Black skin. The reason for this predisposition is unknown.
  • Having a personal or family history of keloids. Keloids can run in families, indicating that the tendency might be inherited. If you've had one keloid, you're at risk of developing others.
  • Being under 30. You're more likely to develop a keloid if you're between the ages of 20 and 30.

Is there a cure/medications for keloids?

The following are keloids treatments. One or more ways may be appropriate for your scenario. Keloids can grow back, sometimes larger than before, even after effective flattening or excision. You might also create new ones.

  • Wound healing: Compression dressings composed of elastic cloth or other materials may be used as the first treatment choice for newer keloids. This treatment is frequently used to remove keloids after surgery. The objective is to lower or avoid scarring by applying pressure to the incision as it heals. A cream containing corticosteroids. Itching can be relieved by using a prescription strength corticosteroid lotion.
  • Medicine: This condition can be treated with cortisone or other hormones to reduce its thickness. Corticosteroid injections may cause skin thinning, spider veins, and a permanent change in skin tone.
  • The scar is frozen. Small keloids can be minimised or eliminated by freezing them in liquid nitrogen (cryotherapy). Treatments may need to be repeated. Blisters, discomfort, and loss of skin tone are all potential risks of cryotherapy.
  • Laser therapy: Pulsed-dye laser sessions can flatten larger keloids. This approach has also been used to relieve itching and diminish keloids. Pulsed-dye laser therapy is administered in a series of sessions spaced 4 to 8 weeks apart.
  • Radiation treatment: Low-level X-ray radiation, used alone or in conjunction with surgical excision of a keloid, can help decrease or minimise scar tissue. Treatments may need to be repeated.
  • Surgical extraction: If your keloid hasn't reacted to other treatments, your doctor may suggest removing it surgically in conjunction with other procedures. Surgery alone has a recurrence rate ranging from 45 to 100 percent.

Scarring that is thick and uneven, usually on the earlobes, shoulders, cheekbones, or middle chest,Skin that is shiny, hairless, bumpy, and elevated,Various sizes, depending on the original damage size and when the keloid finishes growing,Texture ranges from soft to stiff and rubbery,Depending on your skin tone, it could be reddish, brown, or purplish,Itchiness,Discomfort
Keloids on a joint may form hard,Stiff tissue that inhibits movement
Compression dressings made from stretchy fabric,Corticosteroid creams to ease itchiness,Freezing them with liquid nitrogen (cryotherapy),Radiation therapy,Surgery

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