Keloids are smooth, hard growths which form when scar tissue grows. They can be much larger than the original wound, and should not be confused with hypertrophic scars that don’t grow beyond the boundaries of the original wound. The benign keloids can affect any part of the body, especially shoulders, back, earlobes, and upper chest where skin trauma has occurred. These skin scars are often more of a cosmetic concern than a health one. People who have had a keloid in the past should not undergo cosmetic skin surgeries to prevent new growths.
Symptoms usually occur at a site of previous skin injury.
Signs of keloid scars might be:
- Pink or red skin
- Lumpy or ridged area of skin
- Larger than the original scar (development can take months)
- Uncomfortable or tender
- Sensitive to touch
- Irritated by clothing
- Restricted movement (when scarring occurs on a significant amount of the body – happens seldom)
- Discoloration when scar tissue is exposed to the sun
It is not really clear why keloids form. Changes in the cellular signals that control growth and proliferation might be related to the process of keloid development, but these changes have not yet been scientifically established.
All kinds of skin injury may contribute to keloid scarring, such as burns, scratches, ear piercing, acne scars, surgical cuts, etc. In a few cases, the tendency to develop keloids seems to run in the family.
The keloid scars are benign and not contagious. Sometimes they are accompanied by pain, severe itchiness, and changes in texture. In a few cases, keloids can affect movement of skin.
Patients with a known predisposition should avoid unnecessary trauma or surgery, e.g. ear piercing, elective mole removal, etc. In these cases, it would be wise to treat any skin problems, such as infections and acne, as early as possible to minimize areas of inflammation.
Prevention of keloids after trauma or surgery
After surgery, the most effective preventions against keloids are an intact and smooth wound healing as well as a professional wound treatment. In addition, the fresh scar should not be exposed to too many ultraviolet (UV) rays. Sun exposure or tanning may discolor the scar, making it a bit darker than the other skin. Therefore, it is better to keep the scar covered during sun bathing or sport activities. Applying pressure and friction on fresh scars should also be avoided. If the scar is kept supple, the growth of new scar tissue can be prevented. Some doctors recommend special plasters, others suggest taking vitamin C to prevent the formation of keloids.
Removal of keloids
If the keloids are on plainly visible body parts or cause discomfort, they can be removed. However, surgery is not always needed. A keloid lying on the skin surface e.g. can be treated with medication or ointments. Another possibility to remove the scar is the application of “cryotechnology” based on the use of very low temperatures to prevent cell growth. Furthermore, cortisone injections reduce the visibility of keloids. Laser treatment of scars with fractional and ultrapulse CO2 laser belongs to the most modern methods in dermatology. The surgical correction of keloids by post-operation might be another option to remove the scar. However, some doctors warn this may result in the development of another keloid.