A keloid scar is a type of raised scar. Unlike other raised scars, keloids grow much larger than the wound that caused the scar. Keloids do not turn into cancer.
Keloid scar can appear anywhere on the body. 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. 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, surgery tattoo, piercing, or cystic acne. A keloid can also form as chickenpox clear. 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.
Knowing what you expect will help your dermatologist or clinic provide you with realistic information about what treatment can do. It will also help your dermatologist or clinic professional create your treatment plan.
A treatment plan for keloids may include:
Most common treatment for keloids are injections of corticosteroids: 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 4 to 6 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, dermatologist or clinic 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. This treatment is usually done by a plastic surgeon.
To reduce the risk of a keloid returning after surgical removal, dermatologist or clinic 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 keloid is removed 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. It has been found that patients who have 3 or more cryotherapy treatments tend to get the best results.
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.
Keloids and their frequency: Who gets keloids?
Men and women worldwide develop these raised scars. Some people, however, have a higher risk of developing a keloid when they scar. You’re more likely to develop a keloid if you have one or more of the following:
- African, Asian, or Hispanic descent. The keloid is the most common skin condition among ethnic Chinese in Asia. In the United States, keloids are more common in African Americans and Hispanic Americans than whites.
- Family history of keloids. About 1/3 of people who get keloids have a first-degree blood relative (mother, father, sister, brother, or child) who gets keloids. This family trait is most common in people of African or Asian descent.