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During the healing process after an injury, your body produces collagen to repair the wound. Sometimes it produces too much collagen, resulting in a keloid scar. These are thick, rounded clusters of scar tissue that grow outside the edges of the injured area. They are more common in people with darker complexions.

Causes

Keloids are a result of aberrant scar tissue. During normal wound healing, the skin forms scars that gradually shrink and fade over time, but sometimes the skin overreacts and creates thicker, raised scars. Unlike hypertrophic scars, which are raised and do not extend beyond the original margin of an injury, a keloid is much larger and broader in size. It is also thicker than the surrounding skin.

Some people develop only one or two keloids, while others get several. They may appear anywhere on the body, but they are less common on the eyelids, genitals, palms of the hands, or feet.

Itching and pain are the most common symptoms, but keloids can cause other problems as well. For example, when keloids are large enough or on joints, they can restrict movement and limit the ability to reach, walk, or play sports. They can also become cancerous. The scars can also be psychologically distressing for some patients.

Symptoms

Keloids can be itchy and may grow larger than the original wound or surgical scar. They are usually firm, raised, and often pink or red. They can be much bigger than the scar that caused them, and they will grow slowly and sometimes for years. They tend to occur on the ears, arms, shoulders, or chest.

In granuloma and keloid, keloids are not harmful and do not cause any pain, but they can be embarrassing, especially when they are large or in a visible place like the face or earlobe. They can also limit movement.

Doctors diagnose keloids by taking your medical history and conducting a visual examination. If the scar is causing problems, they will do a skin biopsy. There are several treatments for keloids. These include silicone gels and patches, which help flatten the scar and reduce the color and texture, corticosteroid injections, and ligation, which involves tying the keloid to cut off its blood supply. Surgery can be risky because the keloid may return, but it has been successful in some cases.

Treatment

Treatment for keloids includes using silicone gel and tape to reduce the scar’s size and relieve itching. For larger keloids, doctors can use surgery to remove them.

Some people with a genetic predisposition to keloid formation may benefit from avoiding body piercings, tattoos and elective surgeries. Others might benefit from protecting the skin from injury and seeking medical care right away if they develop a wound or scar that becomes inflamed and enlarged.

Small or moderate keloids are usually treated with corticosteroids. Injections of a steroid such as triamcinolone can reduce inflammation and shrink a keloid. Steroid impregnated tape and ointments can also reduce itching and help the scar return to its original shape. For more severe keloids, radiation therapy may be used. Doctors can recommend a dose that is below the so-called biologically effective dose (BED), which would limit the amount of radiation exposure to healthy tissue nearby. This method is effective in reducing the growth of large or multiple keloids and can be safely used on high-recurrence sites such as the chest, shoulder, or abdominal region.

Prevention

It’s normal to get scars when your wounds heal, and they can be a result of many things like burns, accidents, surgical procedures, acne, bug bites, or some types of medical conditions. But keloids are abnormal, and they can develop months or even years after an injury or trauma.

People who have darker skin are more likely to get a keloid than people with lighter skin. This is because they have more melanin in their skin, which can protect them from sun damage, but can also make the scars more noticeable.

Getting treatment as soon as possible will help prevent keloids from forming. Your doctor may recommend using silicone gels or patches to flatten the scar and reduce its appearance. They may also use a ligature to tie the keloid, which cuts off its blood supply and causes it to naturally fall off over time.

For keloids that do not respond to these treatments, surgery may be required. This is often combined with other therapies, such as corticosteroid injections to reduce inflammation and silicone treatments to keep the scar from growing back.