Keloid Scars
Overgrown scar tissue that extends past the original wound
Quick Facts
- Type: Abnormal scar (skin)
- Key feature: Grows beyond the original wound edges
- Common sites: Chest, shoulders, earlobes, jawline
- Tendency: More common with darker skin tones
Overview
Keloid scars are raised, firm, often shiny scars that form when the skin produces too much scar tissue during healing. Unlike an ordinary scar, a keloid grows beyond the edges of the original wound and into the surrounding skin.
Keloids are harmless in the sense that they are not cancer, but they can be itchy, tender, or cosmetically distressing, and they can be difficult to treat because they tend to recur. They form most readily on areas such as the chest, shoulders, upper back, earlobes, and jaw, and are more common in people with darker skin tones.
Symptoms
Keloids develop gradually, sometimes months after the skin injury. Features include:
- A raised, thick scar that extends beyond the original wound
- A smooth, shiny, dome-shaped surface
- Color ranging from pink or red to darker than the surrounding skin
- Itching, tenderness, or a tight, uncomfortable feeling
- Slow growth over weeks to months, sometimes continuing to enlarge
Keloids are usually firmer and larger than a hypertrophic scar, which stays within the wound boundaries. They do not turn into cancer.
Causes
Keloids form because of an overactive healing response in which the body lays down excess collagen. They can follow almost any skin injury, including:
- Cuts, surgery, and burns
- Ear and body piercings
- Acne, chickenpox, and other inflammatory skin conditions
- Vaccinations and minor scratches in prone individuals
Sometimes keloids appear with little or no obvious injury. The exact reason some people form keloids is not fully understood, but a genetic tendency plays a strong role.
Risk Factors
- Darker skin tones, in whom keloids are more common
- A personal or family history of keloids
- Younger age, with onset often between the teens and thirties
- Wounds in high-tension or keloid-prone areas such as the chest, shoulders, and earlobes
- Skin trauma, piercings, and inflammatory skin conditions like acne
Diagnosis
Keloids are usually diagnosed by their appearance and history. A doctor examines the scar, noting that it extends beyond the original wound, and asks about prior injury, piercing, or a tendency to scar. A skin biopsy is rarely needed but may occasionally be done to rule out other skin growths if the diagnosis is uncertain.
Treatment
Keloids can be stubborn and prone to return, so treatment is often combined and tailored to the individual.
- Corticosteroid injections: Injected into the keloid to flatten and soften it; often repeated over time.
- Silicone sheets or gel: Applied over the scar to help flatten it, especially for newer scars.
- Pressure dressings: Sometimes used, particularly after ear keloid removal.
- Cryotherapy: Freezing smaller keloids.
- Surgery: Removal may be done but carries a high chance of recurrence, so it is usually combined with injections, pressure, or other follow-up treatment.
- Other options: Laser therapy and radiation are sometimes used for difficult keloids.
Because results vary and recurrence is common, a dermatologist often guides a combined plan.
Prevention
- If you are prone to keloids, avoid elective skin trauma such as piercings and tattoos
- Treat acne and skin infections promptly to reduce scarring
- Care for wounds well and consider silicone sheets or gel on healing wounds in prone areas
- Tell your surgeon about your keloid tendency before any planned procedure
- Protect new scars from tension and sun exposure
When to See a Doctor
See a doctor or dermatologist if a scar is growing beyond the original wound, becoming itchy or painful, or bothering you cosmetically, especially if you have a history of keloids. Early treatment of a developing keloid tends to work better than treating a large, established one.
Also seek evaluation if a skin lump changes in a way you are unsure about, so it can be properly assessed.
Frequently Asked Questions
What is the difference between a keloid and a hypertrophic scar?
Both are raised scars, but a keloid grows beyond the edges of the original wound, while a hypertrophic scar stays within the wound boundaries. Keloids also tend to be firmer and more prone to recur.
Are keloids dangerous or cancerous?
No. Keloids are benign overgrowths of scar tissue and are not cancer. They can, however, be itchy, tender, or cosmetically distressing, and they may keep growing.
Will surgery remove a keloid for good?
Surgery alone has a high chance of the keloid coming back, often larger. That is why it is usually combined with treatments such as steroid injections, pressure, or other therapies to reduce recurrence.
Can I prevent keloids if I am prone to them?
You can lower the risk by avoiding elective piercings and tattoos, treating acne promptly, caring for wounds well, using silicone sheets on healing wounds, and telling your surgeon about your tendency before procedures.
Do keloids ever go away on their own?
Keloids rarely disappear without treatment. Some may soften slowly over years, but most persist, which is why treatment is considered when they cause symptoms or distress.
References
- American Academy of Dermatology. Keloids: Overview and treatment.
- MedlinePlus, U.S. National Library of Medicine. Keloids.
- Mayo Clinic. Keloid scars.
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS).