Keloid

Definition

A keloid is an extra growth of scar tissue over a skin wound. It grows beyond the margins of the skin wound. A keloid can be thick and differ in size from small to large. They are not harmful to overall health.

Keloids are found anywhere on the body. They are more common on:

• Earlobes
• Shoulders
• Upper back
• Chest
• Back of scalp and neck
• Knees

Causes

Scar tissue is a part of the normal healing process. It grows in an uncontrolled manner. Even if the wound is covered, the scar will grow. The growth can last for weeks or months.

Risk Factors

Keloids are more likely in people who are aged 10 to 30 years old.

Things that raise the risk of a keloid:

• Deep skin wounds such as those from infections, burns, or surgery
• Family history of keloids
• Elevated hormone levels as with puberty or pregnancy

Normal Surgical Scar.

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Symptoms

Keloids often begin as small lumps at the site of a skin injury. They gradually grow beyond the edges of the wound.

For most, the scar is the only symptom. Others may have:

• Soreness or pain
• Burning
• Itching

Diagnosis

The doctor will ask about symptoms and past health. A physical exam will be done. The symptoms and exam may be enough to diagnose a keloid. Tests are rarely needed.

Treatment

Some keloids may go away on their own, but this is rare. Keloids do not need treatment unless they are bothersome.

Care for a large or bothersome keloid may involve surgery, lasers, or shots.

If surgery is done, the doctor may take steps to prevent it from growing back. This may involve:

• Corticosteroid shots—Often given with surgery. This is repeated every 3 to 4 weeks for 6 months. Steroids can ease itching and pain. They also slow scar development and cause some shrinking of the keloid in some people.
• Medicine may be injected into the area or applied as a cream after the surgery.
• Silicone gel sheets—A watertight seal is placed over the scar for an extended period of time. It helps the skin heal while keeping out bacteria and dirt that may worsen scarring.
• Skin hydration (including topical moisturizer) and sunscreen.
• Pressure earrings, garments, or bandaging—to reduce blood flow.
• Radiation therapy after surgery. This may be limited as an option because it is toxic to healthy tissue.

Prevention

To help lower the risk of a keloid:

• Take steps to protect skin from trauma.
• Care for cuts and scrapes right away.
• Avoid unnecessary cosmetic surgery.
• Do not tattoo or pierce ears or other areas of the body.