Keloid

Overview

A keloid is a type of raised scar that grows beyond the edges of the original skin injury. It develops when the skin produces too much scar tissue during the healing process. Keloids can appear after cuts, burns, acne, piercings, surgery, vaccinations, or other skin injuries. In some people, they may also form after very minor skin damage that was not noticed at the time.

Keloids are not cancer and do not turn into cancer. However, they can cause discomfort, itching, tenderness, or cosmetic concerns. They may be firm, smooth, shiny, and darker or lighter than the surrounding skin. Keloids can continue to grow slowly over time, and they may return after treatment, especially in people who are prone to developing them.

Common locations include the chest, shoulders, upper back, earlobes, neck, jawline, and areas where the skin is under tension. Keloids can affect people of any age, but they are more common in younger adults and in people with darker skin tones.

Symptoms

The main sign of a keloid is a raised area of scar tissue that extends beyond the original wound. The appearance and symptoms can vary from person to person.

• A firm, thick, or rubbery raised scar
• A smooth, shiny surface
• Color changes, such as pink, red, brown, or darker pigmentation
• Itching, tenderness, or sensitivity
• Pain or a burning sensation in some cases
• Slow enlargement over weeks, months, or longer
• Tightness or reduced movement if the keloid is near a joint

Some keloids remain stable and cause few symptoms, while others become more noticeable or uncomfortable. The emotional impact should not be underestimated, particularly when keloids are visible on the face, neck, chest, or ears.

Causes and Risk Factors

Keloids form because the body’s wound-healing response becomes overactive. Normally, the skin produces collagen to repair damage. In a keloid, collagen continues to build up beyond what is needed, creating a raised scar that spreads outside the original injury site.

Several factors may increase the likelihood of developing keloids:

• Personal or family history of keloids
• Darker skin tones
• Previous keloid after piercing, surgery, acne, or burns
• Skin injuries in areas with tension, such as the chest or shoulders
• Ear piercing, body piercing, or tattooing
• Inflammatory skin conditions such as acne
• Younger age, particularly adolescence and early adulthood

Keloids are not caused by poor hygiene and are not contagious. A person cannot spread a keloid to another person through contact.

Diagnosis

A dermatologist can often identify a keloid by examining the skin and asking about the history of the scar, including when it appeared, whether there was an injury, and whether it has changed over time. The doctor may also ask about previous scars and family history.

In most cases, no special tests are needed. If the appearance is unusual, if the area is changing rapidly, or if another skin condition needs to be ruled out, the doctor may recommend further evaluation. This may include removing a small sample of tissue for laboratory examination. The purpose is to confirm the nature of the skin growth and exclude other conditions that can resemble scars.

It is important not to assume that every raised skin growth is a keloid. A medical assessment can help guide the most appropriate management and avoid unnecessary irritation or ineffective approaches.

Treatment Options

Treatment depends on the size, location, symptoms, cosmetic concerns, and whether the keloid is growing. Keloids can be challenging to treat, and recurrence is possible. A dermatologist may suggest one treatment or a combination of treatments to reduce symptoms, flatten the scar, or improve appearance.

• Silicone-based scar therapy: Silicone sheets or gels may help soften and flatten some scars when used as advised by a healthcare professional.
• Pressure therapy: Special pressure garments or earrings may be recommended for certain keloids, especially after ear procedures.
• Injections: Medicines injected into the keloid may help reduce thickness, itching, or tenderness. The choice and schedule are determined by the doctor.
• Cryotherapy: Controlled freezing may be used for selected smaller keloids to reduce size and firmness.
• Laser treatment: Lasers may help with redness, texture, or thickness in some cases.
• Surgical removal: Surgery may be considered for selected keloids, but it is often combined with other methods because new keloid formation can occur after cutting the skin.
• Radiotherapy: In specific cases, carefully planned radiotherapy may be considered after surgical removal to reduce recurrence risk.

Because keloids may worsen after injury, people who are prone to them should discuss risks with a dermatologist before elective piercings, tattoos, or cosmetic procedures. Early management of acne and careful wound care after medical procedures may also help reduce irritation and inflammation.

When to See a Doctor

Medical advice is recommended if a raised scar is growing, painful, itchy, bleeding, or causing emotional distress. A dermatologist can assess whether the lesion is a keloid and discuss suitable options based on the individual situation.

You should also seek medical evaluation if a scar changes quickly, develops an open sore, becomes infected, limits movement, or appears without a clear reason. People with a history of keloids may benefit from consultation before planned skin procedures, such as surgery, piercing, or cosmetic treatments.

Keloids are common and benign, but they can be persistent. With professional assessment and a tailored management plan, many people can reduce discomfort and improve the appearance of the scar over time.