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Keloids

  • Definition
    • A keloid is a growth of extra scar tissue where the skin has healed after an injury.

  • Alternative Names
    • Hypertrophic scar; Keloid scar; Scar - hypertrophic

  • Causes
    • Keloids can form after skin injuries from:

      • Acne
      • Burns
      • Chickenpox
      • Ear piercing
      • Minor scratches
      • Cuts from surgery or trauma
      • Vaccination sites

      Keloids are most common in people ages 10 to 20, and in African Americans, Asians, and Hispanics. Keloids often run in families. Sometimes a person may not know what injury caused a keloid to form.

  • Symptoms
    • A keloid may be:

      • Flesh-colored, red, or pink
      • Located over the site of a wound or injury
      • Lumpy or ridged
      • Tender and itchy
      • Irritated from friction such as rubbing on clothing

      A keloid will tan darker than the skin around it if exposed to sun during the first year after it forms. The darker color may not go away.

  • Exams and Tests
    • Your doctor will look at your skin to see if you have a keloid. A skin biopsy may be done to rule out other types of skin growths (tumors).

  • Treatment
    • Keloids often do not need treatment. If the keloid bothers you, these things can be done to reduce the size:

      • Corticosteroid injections
      • Freezing (cryotherapy)
      • Laser treatments
      • Radiation
      • Surgical removal
      • Silicone gel or patches

      Sometimes these treatments cause the keloid scar to become larger.

  • Outlook (Prognosis)
    • Keloids usually are not harmful to your health, but they may affect how you look. Sometimes they become smaller, flatter, and less noticeable over time.

  • When to Contact a Medical Professional
    • Call your health care provider if:

      • You develop keloids and want to have them removed or reduced
      • You develop new symptoms
  • Prevention
    • When you are in the sun:

      • Cover a keloid that is forming with a patch or Band-Aid.
      • Use sunblock.

      Continue to follow these steps for at least 6 months after injury or surgery for an adult, or up to 18 months for a child.

      Imiquimod cream can be used to prevent keloids from forming after surgery, or from returning after they are removed.

  • References
    • Juckett G, Hartman-Adams H. Management of keloids and hypertrophic scars. Am Fam Physician. 2009;80(3):253-260.

      Romanelli R, Dini V, Miteva M, et al. Dermal hypertrophies. In: Bolognia JL, Jorizzo JL, Schaffer JV, et al, eds. Dermatology. 3rd ed. Philadelphia, PA: Elsevier Mosby; 2012:chap 98.

      Ud-Din S, Bayat A. New insights on keloids, hypertrophic scars, and striae. Dermatol Clin. 2014;32(2):193-209.