Keloids

A keloid is a type of raised scar. Unlike other raised scars, keloids grow much larger than the wound that caused the scar.

Not everyone who gets a scar will develop a keloid. If you have keloid-prone skin, however, anything that can cause a scar may lead to a keloid. This includes a cut, burn, or severe acne. Some people see a keloid after they pierce their ears or get a tattoo. A keloid can also form as chickenpox clear. Sometimes, a surgical scar becomes a keloid.

In very rare cases, keloids form when people do not injure their skin. These are called “spontaneous keloids.”

A keloid usually takes time to appear. After an injury, months can pass before this scar appears. A keloid can also form more quickly.

Once it begins, a keloid can enlarge slowly for months or years. Symptoms
As these raised scars grow, they may feel painful or itchy. A keloid that covers a joint or large area can decrease a person’s ability to move that part of the body.

No one treatment is best for all keloids. To give their patients the best results, dermatologists choose treatment based on the patient’s age, type of keloid, and other considerations. Most people get these scars after they injure their skin, such as from a cut or puncture wound. Getting a tattoo or piercing can also cause a keloid.

Sometimes, a surgical scar turns into a keloid. Some women who have had a cesarean section (C-section) or hysterectomy get keloids after the surgery.

Some people get keloids when serious acne clears or chickenpox fade. It’s also possible to get a keloid after getting an insect bite or shot for a vaccine.

Wearing tightly braided hair causes keloids in a few people.

Some men who shave their face develop keloids in their beard area.

It’s also possible for keloids to form on uninjured skin. These keloids are called “spontaneous keloids.” They usually appear on the chest and develop in people who have a family history of developing keloids. When keloids develop spontaneously, it’s more likely that several keloids will appear.

Treatment
Injections of corticosteroids and other medicines: These injections are often part a treatment plan for keloids. When injected into the keloid, these medicines help to shrink the scar.

Patients usually receive a series of injections once every 3 to 4 weeks. On average, patients return about 4 times for these injections. The first injections tend to relieve symptoms and make the keloid feel softer.

Between 50% and 80% of keloids shrink after being injected. Many of these keloids, however, will regrow within 5 years. To improve results, dermatologists often add another therapy to the treatment plan.

Surgical removal (keloid surgery): This treatment involves surgically cutting out the keloid. While this may seem like a permanent solution, it’s important to know that nearly 100% of keloids return after this treatment.

To reduce the risk of a keloid returning after surgical removal, dermatologists often treat patients with another keloid treatment after the surgery. Injections of corticosteroids or cryotherapy may help reduce the risk. If the keloid is on an earlobe, wearing a special earring that puts pressure on the earlobe can prevent the keloid from returning.

Pressure earring, dressing, or garment: This is often used after keloid surgery. Putting pressure on the area reduces blood flow, which can stop a keloid from returning.

Between 90% and 100% of patients who use this treatment as directed after keloid surgery can prevent another keloid.


Using this as directed, however, can be difficult. These devices tend to be uncomfortable. To get results, a patient must wear it for up to 16 hours a day for 6 to 12 months.

The pressure earring tends to be easiest to wear. It is often recommended after a dermatologist removes a keloid from an earlobe.

Laser treatment: This can reduce the height and fade the color of a keloid. It’s often used along with another treatment like a series of corticosteroid injections or pressure.

Silicone sheets and gels: These may be used along with pressure to prevent a keloid from returning.

Sometimes, silicone is used alone to flatten a keloid. In one study, 34% of the raised scars had some flattening after patients used the silicone gel daily for 6 months.

Cryotherapy: This treatment freezes the keloid from the inside out while saving the skin beneath the keloid. It’s used to reduce the hardness and size of a keloid. Cryotherapy works best on small keloids.

Having a few cryotherapy treatments before (or after) receiving injections of corticosteroids may reduce the size of a keloid. This can make the injections more effective.

Dermatologists have found that patients who have 3 or more cryotherapy treatments tend to get the best results.

PRP platelet rich plasma therapy is the newest modality for treating keloids. It is usually combined with other modes of therapies.

What is the outcome after treatment for a keloid?

Treatment can reduce the size of keloid. It can reduce symptoms like pain and itch. Sometimes, treatment gets rid of a keloid.

Even after successful treatment, some keloids return. Following your dermatologist’s instructions can help you reduce the chance of a keloid returning. It will also help you get the best results from treatment.