Keloids

Understanding and Managing Overgrown Scars

Keloids are overgrowths of scar tissue that develop after skin injuries. Unlike typical scars, keloids extend beyond the original wound site and can continue to grow for months or even years. They commonly occur after trauma such as cuts, surgery, acne, burns, and even minor skin injuries like piercings. People with darker skin tones—especially those of African, Asian, or Hispanic descent—are more prone to developing keloids. They are not harmful but can cause discomfort and cosmetic concerns.

Symptoms and Appearance

Keloids can vary in appearance but often share the following traits:

  • Flesh-colored, pink, or red
  • Raised and lumpy, sometimes with a shiny surface
  • Itchy or tender to the touch
  • May be irritated by friction from clothing

Causes

Keloids form as a result of the body’s excessive healing response to skin trauma. Injuries that commonly lead to keloids include:

  • Acne
  • Burns
  • Ear or body piercings
  • Vaccination sites
  • Cuts or surgery

Diagnosis

A dermatologist can usually diagnose a keloid based on its appearance. In rare cases, a skin biopsy may be required to rule out other conditions.

Treatment Options

While keloids do not always require treatment, many patients seek help to reduce their size or alleviate symptoms like itching and discomfort. Dermatologists often recommend a combination of approaches for the best results.

  1. Corticosteroid Injections: The most common treatment for keloids. Injections reduce inflammation and soften the scar, but multiple treatments are usually required.
  2. Cryotherapy: Freezing the keloid to reduce its size, often used in combination with injections.
  3. Surgical Removal: Keloids can be surgically removed, but recurrence is common unless combined with other treatments.
  4. Laser Therapy: Reduces the height and fades the color of keloids.

Prevention

Preventing keloids can be difficult, but steps like protecting healing skin from the sun and avoiding unnecessary piercings or surgeries can reduce the risk. Applying imiquimod cream after surgery may help prevent new keloids from forming.