What is a keloid?
Keloids are overgrown scars caused by excessive production of collagen during the skin's healing process. Unlike normal scars, which usually form within the boundaries of the original injury, keloids can spread into surrounding healthy skin. They are more common on certain parts of the body, such as the chest, shoulders, upper arms and earlobes, and can vary in size. Keloids are benign (non-cancerous) but can be cosmetically bothersome and sometimes cause discomfort.
How does a keloid develop?
Keloids develop when the body produces too much collagen during the healing process after an injury or skin trauma. This can happen after injuries such as cuts, surgical procedures, burns, vaccinations, piercings or even insect bites. Although the exact cause of keloid formation is unknown, genetic factors play an important role, because people with a family history of keloids are at higher risk of developing them. Keloids are also more common in people with dark skin.
What are the symptoms of a keloid?
Keloids appear as thick, raised scars that extend above the skin surface. They can vary in colour from pink to dark brown and often have a smooth, shiny texture. Although they usually cause no pain, keloids can sometimes itch, cause pain or give a burning sensation, especially as they grow. They can also be cosmetically bothersome, especially if they are on visible parts of the body.
Treatment options for keloids
There are several treatment options for keloids, although no single method offers a full guarantee of success, and keloids can come back after treatment. Some of the most commonly used treatments are:
- Corticosteroid injections: Steroid injections can help reduce keloids by reducing inflammation and collagen production.
- Surgical removal: Keloids can be removed surgically, but there is a risk that the keloid will come back and possibly become larger than before.
- Laser therapy: Lasers can be used to flatten keloids and reduce their colour.
- Cryotherapy: In cryotherapy, the keloid is frozen with liquid nitrogen, which can help reduce its size, especially in smaller keloids.
- Silicone gel or sheets: Applying silicone to the keloid can help soften and reduce the scar.
- Pressure dressings: These can help reduce the growth of keloids, especially after surgical procedures.
When is treatment for a keloid needed?
Treatment for a keloid is usually not medically necessary, because keloids are benign. However, many people choose treatment for cosmetic reasons or because of discomfort, such as itching or pain. Patients who are prone to developing keloids should be careful when considering surgical procedures or piercings and should consult their doctor about preventive measures to minimise keloid formation.
The difference between a keloid and a hypertrophic scar
Keloids and hypertrophic scars are often confused, but they differ in their growth and appearance. Like keloids, hypertrophic scars are thick and raised, but they stay within the boundaries of the original wound. Keloids, on the other hand, spread beyond the original wound boundaries. Hypertrophic scars can fade and flatten over time, whereas keloids often keep growing and do not go away on their own.
Risks and considerations
Although keloids themselves do not pose a health risk, they can be physically uncomfortable and cause psychological stress because of their appearance. People who are prone to keloids should be careful with skin trauma and medical procedures such as piercings or surgical procedures that can increase the risk of keloid formation. Treatment options should be carefully considered, and the possibility of keloids returning after treatment should be discussed with the doctor.
Conclusion
Keloids are abnormal scars caused by excessive collagen production during the skin’s healing process. Although they are benign, they can be cosmetically bothersome and sometimes uncomfortable. Various treatment options are available, but none of them offers a certain solution. It is important to carefully weigh the risks and benefits of treatment and to consider preventive measures to minimise keloid formation, especially for people who are prone to developing keloids.
See also our page about Scar correction.
