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Keloids, also called keloid scars, are a type of scar tissue that usually grows at the site of an injury. They can also result from infection, inflammation, surgery, blisters, acne, and body piercings.
It is not clear why keloids form, but they are harmless — they do not turn into cancer. They eventually stop growing and do not change after that point.
While many treatments are available, keloids can grow back.
This article explores keloids in more depth, including how they differ from other types of scar, and the treatments available.
A keloid is a shiny, smooth, raised formation of scar tissue.
The appearance may vary, however, depending on the location. For example, on the ear, a keloid may be solid and round, while one on the chest may be more spread out.
Keloids can form on the:
These scars tend to be pink, purple, or brown and may feel firm or rubbery. They can vary in size and may be darker than the rest of the skin.
As the British Skin Foundation note, they typically occur due to injury, inflammation, or infection.
Keloids usually grow larger than the wound that caused them.
Keloid scars form months after the injury responsible. The American Academy of Dermatology (AAD) observe that it may take 3–12 months for a keloid to become noticeable.
These scars may feel itchy or sore while they are growing, but the symptoms stop when the keloid stops developing.
While the exact causes are unclear, the British Association of Dermatologists note that keloids may grow because the body produces too much collagen when a scar forms in response to an injury.
Collagen is a protein that the body produces to maintain elasticity in the skin. It also gives structural support to the muscles, bones, and tissues.
Various factors can increase the chances of developing keloid scars, including:
- Age: Keloids are more common in people aged 10 to 30 years old.
- Ethnicity: The AAD state that in the United States, keloids are more common in people of Asian, Latinx, and African descent.
- Injury location: Keloids are more likely to grow on the upper back, shoulders, and chest, where the skin is tighter.
- Genetics: Around one-third of people who develop keloids have a close relative who also does so.
- Hormonal changes: Hormonal changes — such as in people who are pregnant or have hypertension or a thyroid condition — may increase the odds of developing keloid scars.
Hypertrophic scars look similar to keloid scars, but there are some key differences.
As the American Osteopathic College of Dermatology report, hypertrophic scars:
- are more common than keloid scars
- fade over time
- do not grow as large as keloid scars
A person might try to treat keloids by using:
A person might try crushing aspirin tablets and mixing them with water to form a paste, then applying this to the area. However, stop using the paste if any skin irritation occurs.
However, if applying garlic to the area causes any irritation, stop right away.
Honey can reduce the size of keloids because it curbs inflammation, according to a 2015 review.
A person might try applying raw honey to the affected area.
Onion can stop cells called fibroblasts, which create scar tissue, from entering the skin, a 2013 study found.
An earlier study found that onion gel reduced keloid size.
A person might apply the juice of an onion to the scar. Rinse the juice off once it has dried.
There are various professional treatments for keloid scars, and a dermatologist may recommend one or more of the following options:
Also called intralesional injections, this involves a healthcare professional injecting steroids directly into a scar to reduce its size. This is the most common medical treatment for keloids.
The AAD state that the injection can be repeated every month. A person may have to return for this treatment about four times before the keloid goes away.
It may be worth noting, however, that 50–80% of keloids grow back after this treatment.
A dermatologist may recommend steroid creams or tapes that contain steroids.
According to the Primary Care Dermatology Society, 9–50% of keloids come back after this treatment.
Cryotherapy involves freezing off a keloid. It typically works better for smaller scars.
Laser and light therapy
This may be particularly successful in combination with steroid injections, though a review has highlighted the lack of specific information about the effectiveness of this option.
Surgery to remove a keloid is typically a last resort, as it may cause a larger scar to develop.
A dermatologist may perform it as part of a plan that includes other treatments.
Radiotherapy can reduce the size of a keloid, and it typically produces better results if it takes place after surgery.
Applying pressure after surgery can reduce blood flow to the area, which may prevent a keloid from returning.
A person may need to wear the compression device for up to 16 hours a day for 6–12 months.
If a person is concerned about their chances of developing keloids, they may wish to avoid piercings, cosmetic surgery, and tattoos.
It is also important to practice proper wound care:
- Wash the area immediately using soap and clean water.
- Use sterile petroleum gauze to bandage the area.
- Clean the wound daily until it has healed.
- Protect the wound from the sun.
While the wound is healing, a person might also try using silicone sheets or gel to shield it.
If a keloid scar becomes large, itchy, or it reduces the flexibility of a joint, seek medical advice.
If the appearance of a keloid causes distress, discuss this with a doctor, who can help develop a suitable treatment plan.
A keloid is a smooth, raised, shiny scar that is usually larger than the original injury and darker than the surrounding skin.
The success of treatments can vary, and a doctor can help a person develop a treatment plan that suits them best.
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