Keloids: All You Need To Know

What causes keloid scarring? A keloid scar is an enlarged, elevated scar that may be pink, red, flesh-colored, or darker than the surrounding skin. Keloid scars can develop as a result of skin damage and they can grow bigger if left untreated or with repeated injury.

A protein called collagen that is present throughout the body aids in wound healing, but when the body generates too much of it, keloids can develop. Skin injuries such as bug bites, acne, injections, body piercings, burns, hair removal, and even minor scrapes and bumps can cause keloid formation.

Manifestations of Keloids

If you notice any of the following, you may have a keloid scar:

• It starts as a raised scar that is pink, red, or purple
• A keloid is often a raised scar with a flat surface that darkens over time to become darker than the surrounding skin
• Has a darker border than the surrounding skin.

It may take up to 3 to 12 months or even longer before you detect the first signs of a keloid developing. The majority typically manifest a year after the initial skin damage. It may also expand swiftly. For instance, keloids can develop three times their original size in as little as a few months.

If your scar itches, is painful, or hurts, these symptoms normally go away after the keloid forms.

If your scar is readily inflamed, friction, such as rubbing against clothing, might cause it to itch.

Keloids can appear anywhere, but the American Academy of Dermatology reports that they’re less common on the eyelids, genitalia, soles of the feet, or palms of the hands. Instead, they frequently appear on your ears, neck, shoulders, chest, and back.

In addition, keloids can be more than just skin imperfections. Depending on the size of the scar and where it is on the body, it may impair movement. 

Causes and Risk Factors

Although the exact cause of keloids in some people is unknown, doctors believe that these types of scars occur when fibroblasts, which are collagen-secreting cells found in our connective tissue, overreact to the injury. When skin is injured, fibrous tissue known as scar tissue forms over the incision to heal and protect the injury. However, in some situations, excess scar tissue grows, generating smooth, hard growths known as keloids.

Any skin injury that leaves a scar, such as a surgical cut, or any other type of cut, acne scars, chicken pox scars, burns, body piercings, tattoos, insect bites, vaccinations, or wearing tightly braided hair might result in the development of keloids if you are predisposed to them.

Rarely, keloids can develop spontaneously on uninjured skin. These are known as spontaneous keloids.

The following are risk factors that raise your likelihood of acquiring keloids:

• Being of African, Asian, or Hispanic descent
• Having a family history of keloids
• Being between the ages of 10 and 30
• Most people first notice keloids developing on their skin in their 20s, though these scars can start earlier or later

Will They Go Away on Their Own?

While keloids rarely go away on their own, they may flatten and soften over time but rarely disappear completely. For some people, these natural changes are enough to make keloids look better but, even so, the skin never looks the same as before. Keloids can continue to grow for months or even years before they eventually stop growing. But they do not disappear without treatment. 

Even though keloids are benign (noncancerous) growths, they are still challenging to treat. They may also recur after being surgically removed. However, your dermatologist may be able to recommend steps that can help decrease the likelihood of keloids returning after treatment or at least ways to minimize their appearance.

Treatment

People may seek treatment for keloids if the scar affects their self-esteem and how they feel about their appearance. For instance, if the scar is large or is located in a very visible place on your body, your doctor may be able to help you find ways to reduce the size and prominence. If a keloid is smaller before (or after) receiving injections of corticosteroids, this may increase the effectiveness of the injections (if it covers a joint or a large area, for example),

Keloids are difficult to completely eradicate, and using more than one type of treatment often improves results, so dermatologists frequently recommend two or more types of treatments for their patients. There is no one treatment that works best for all keloids. Instead, dermatologists customize the treatment to the individual based on factors like age and type of keloid.

Keloid scar therapy possibilities include:

Surgery

Keloids recur after surgical removal in about 100% of instances. Hence, surgery is generally accompanied by additional therapies like corticosteroid injections or silicone treatments.

Cryotherapy

This treatment involves freezing the keloid from the inside out. It is most successful for smaller keloids. It is frequently applied before or after corticosteroid injections to increase the effectiveness of the injections.

Pressure Therapy

Pressure therapy involves applying pressure to the area and reducing blood flow to the site to inhibit the regrowth of the keloid. While effective, pressure therapy, which is frequently used after surgery, can be challenging for many people to adhere to because it can be uncomfortable and people need to wear them for 6 to 12 months.

Radiation treatment

Following surgery, low-dose radiation therapy may aid in preventing the scar from healing.

Laser treatment

Laser therapy is frequently used in conjunction with other procedures like pressure therapy or corticosteroid injections to reduce the size and lighten the color of keloid growths.

Silicone patches and gels

These silicone-based therapies aid in flattening scars and minimizing their size and color.

Ligature

Your doctor can decide to tie a surgical thread around the keloid to cut off the blood flow, allowing the keloid to fall off spontaneously over time.

Prevention

Applying silicone sheets or gel can help prevent keloids from forming and reduce the size of existing scars. Use silicone sheets or gel as soon as the incision heals to get the protection you require.

If you are prone to getting keloids, take precautions to stop the development of scars. Here are some advice from aad to remember:

• Treat any injury right away, regardless of how minor it may be; this may help your skin heal faster and lower your chance of scarring.
• Avoid getting body piercings, tattoos, or any elective surgery as keloids can develop following these treatments.
• If you do sustain a wound, consult your dermatologist for advice on how to effectively treat and dress it to avoid the development of keloid scars.

Key Takeaways

A keloid is a type of scar that forms as a wound heals. Keloids aren’t dangerous, but they can be bothersome and affect your self-esteem. There is no way to prevent keloids from forming, but there are treatments that can help minimize their size and appearance. Consult your doctor and dermatologist regarding available treatments and procedures. 

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