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What are keloids?

When a wound heals, it leaves a scar. A keloid (also called a keloid scar) is the name given to a scar that overgrows and becomes larger than the original wound. It is not uncommon for a scar to become slightly thick and raised. This is called a hypertrophic scar. Unlike hypertrophic scars, keloids:

  • Can develop after very minor skin damage, such as an acne spot, or sometimes without any obvious trauma to the skin (spontaneous keloids).
  • Spread beyond the original area of skin damage.
  • May be permanent.

What causes keloids?

This is not fully understood, but keloids happen when there is over production of collagen (the skin’s structural protein).

Keloid scars

– Can affect anyone, but they are more common in people with dark skin (especially those of African, Hispanic or Chinese descent)
– Are more common after skin injury on the upper chest, breastbone (sternum), shoulders, chin, neck, lower legs and earlobes (especially after ear piercing)
– Are most likely to form following burns, acne scars and wounds that become infected or are under tension whilst healing
– May develop from surgical scars
– Are more likely to affect people who have previously had a keloid if their skin is damaged again.

Can a keloid be removed?

Surgically removing/ excising or “cutting out” a keloid is not always successful as the keloid can regrow. If it is excised, the risk of regrowth may be reduced by compression dressings or steroid injections following the procedure

How can a keloid be treated?

Treatment can sometimes help to flatten them and reduce irritation. Treatment options include:

  • Injection of a steroid into the keloids. This is the most common treatment. Injections can be repeated e.g. monthly for 4-6 months. Steroids can make the skin thin, fragile and pale. Up to 50% of keloids grow back.
  • Applying a strong steroid cream or steroid-containing tape. These require a prescription.
  • Silicone dressings or gel are safe and can be bought from a pharmacist without prescription. If used for several months they can reduce the thickness and make the keloid paler.
  • Cryotherapy can be tried alone or in combination with other treatment methods. It can cause loss of skin pigment.
  • Laser therapy can help, especially if combined with injected steroids.

https://patient.info/health/keloid-leaflet https://www.dermnetnz.org/topics/keloids-and-hypertrophic-scars

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