What Is a Keloid and How Can It Be Treated?

Scars are a natural part of the healing process following an injury, surgery, or even acne. While most scars fade over time and remain flat, some can develop into something more prominent—keloids. These raised, overgrown scars not only affect appearance but can also cause discomfort. In this article, we’ll explore what keloids are, what causes them, and the various treatment options available.

Understanding Keloids

A keloid is an abnormal growth of scar tissue that forms at the site of a healed skin injury. Unlike regular scars, which remain confined to the wound area, keloids extend beyond the original injury, often becoming larger over time. They can appear anywhere on the body but are most commonly found on the chest, shoulders, earlobes, cheeks, and upper back.

Keloids are typically:

• Raised and firm to the touch
• Smooth on the surface
• Flesh-colored, red, or pink, which may darken over time
• Itchy, tender, or painful in some cases

While keloids are benign (non-cancerous), they can cause emotional distress or self-consciousness due to their appearance, especially when located in visible areas.

What Causes Keloids?

Keloids form when the body produces excess collagen during the healing process. Collagen is a protein that helps rebuild skin, but in some individuals, this response becomes overactive, resulting in a thick, bumpy scar that keeps growing even after the wound has healed.

Common triggers include:

• Surgical incisions
• Cuts or burns
• Acne scars
• Chickenpox scars
• Vaccination sites
• Ear piercings
• Tattoos

Genetics play a significant role in keloid development. People with darker skin tones—particularly those of African, Asian, or Hispanic descent—are more prone to keloids. They also tend to occur more frequently in individuals between the ages of 10 and 30.

Risk Factors for Keloid Formation

Certain factors increase the likelihood of developing keloids:

• Family history of keloids
• Skin trauma or tension in the affected area
• Hormonal changes (e.g., during puberty or pregnancy)
• Chronic skin inflammation

It's important to note that while keloids are more common in certain populations, anyone can develop them.

How Are Keloids Diagnosed?

Most keloids can be diagnosed through a simple physical examination by a dermatologist. In rare cases, a skin biopsy may be performed to rule out other types of skin growths, such as dermatofibromas or skin cancers.

Treatment Options for Keloids

Treating keloids can be challenging because they have a high recurrence rate. Often, a combination of therapies yields the best results. Common treatment approaches include:

1. Corticosteroid Injections

One of the most common treatments involves injecting corticosteroids directly into the keloid. This helps reduce inflammation, flatten the scar, and relieve itching or discomfort. Injections are typically repeated every 3 to 4 weeks and may cause side effects such as skin thinning or discoloration.

2. Surgical Removal

Surgery can be used to cut out the keloid, but it carries a high risk of recurrence—sometimes resulting in an even larger keloid. To minimize this risk, surgery is often combined with other treatments, such as steroid injections or radiation therapy, post-operatively.

3. Laser Therapy

Pulsed dye lasers or fractional lasers can help flatten keloids and reduce redness. Multiple sessions are usually required, and this method is often used in combination with other treatments.

4. Cryotherapy

This treatment involves freezing the keloid with liquid nitrogen to shrink it. It’s most effective for smaller keloids but may cause skin lightening, especially in people with darker skin.

5. Silicone Sheets or Gels

Applying silicone-based products regularly can help flatten and soften keloids over time. They are non-invasive and often recommended for new or mild keloids.

6. Pressure Therapy

Using special bandages or garments that apply constant pressure to the scar can help prevent keloid formation, especially after surgery or burns.

7. Radiation Therapy

In severe or recurring cases, low-dose radiation may be used after surgical removal to prevent regrowth. This is typically reserved for difficult-to-treat keloids due to potential long-term risks.

Preventing Keloids

For those prone to keloids, prevention is key:

• Avoid unnecessary piercings, tattoos, or elective surgeries.
• Take proper care of wounds to minimize scarring.
• Consider using silicone sheets or pressure dressings on healing scars.
• Consult a dermatologist before undergoing any skin procedures.

Living with Keloids

While keloids are not medically dangerous, they can impact self-esteem and quality of life. If you’re struggling emotionally, talking to a counselor or joining a support group can be beneficial.

When to See a Doctor

Consult a dermatologist if:

• A scar continues to grow long after the injury has healed
• The keloid causes pain, itching, or restricts movement
• You're considering treatment options

Final Thoughts

Keloids are more than just scars—they’re a complex overgrowth of tissue that requires careful management. While they can be difficult to treat and prone to recurrence, advances in dermatology offer a range of effective options. Early intervention and preventive measures are crucial, especially for individuals at higher risk.

If you suspect you have a keloid or are planning a procedure that could lead to scarring, speak with a qualified healthcare provider to explore the best course of action. With the right approach, it's possible to improve both the appearance and comfort of keloid scars.

Always consult a medical professional before starting any treatment for keloids. Individual results may vary, and what works for one person may not be suitable for another.