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A keloid scar is a thick, elevated scar that remains on the skin after a wound has healed. It typically develops a few weeks to years following skin damage or injury, such as acne, burns, or cuts. One’s physical health will not be harmed by a keloid scar, but it may cause mental distress. The key is early detection and treatment.
Although it can appear anywhere there is skin damage, it typically manifests on the chest, shoulders, cheeks, or earlobes. If one is prone to getting keloids, there may be multiple sites where they form. A keloid scar typically enlarges over the course of months or years, surpassing the size of the initial wound.
Keloid scar could hurt or itch while it is growing. If it is on or close to a joint, it may cause discomfort or make movement in the joint problematic. Treatment may include flattening or removal of the keloid scar. However, it can recur or last for years even after treatment.
Symptoms
A keloid scar can develop anywhere from a few months to several years after the initial injury or trauma occurs. Signs and symptoms of a keloid scar include:
- Lumpy, shiny, hairless, and raised skin
- Varying in size, based upon the extent of the initial damage and the point at which the keloid ceases to grow
- Texture may vary from soft to firm and rubbery
- Depending on the skin tone, color can range from a reddish hue to brown or purplish
- Thick, uneven scarring, usually on the middle chest, shoulders, cheeks, and earlobes
- Itchiness
If one suspects or is bothered by a keloid scar, it is recommended to consult a healthcare provider for proper diagnosis and treatment. The healthcare provider can give suggestions for improving its appearance, and early intervention could potentially halt the continued growth of the keloid scar.
Causes
Keloid scars have no definite cause. It may develop without an apparent reason. However, it is important to note that keloids are neither contagious nor cancerous.
A keloid differs from a hypertrophic scar in that a hypertrophic scar remains confined to the area of the initial wound and may naturally diminish over time without the need for treatment.
Researchers believed that various skin injuries, such as insect bites, acne, injections, body piercings, burns, hair removal, and even minor scratches and bumps, can potentially trigger keloid growth. Most concur that it is probably a dysfunction in the wound-healing process. It can also occur due to excessive collagen production. Collagen is the protein present throughout the body and essential for wound healing.
Risk factors
Several factors may contribute to one’s risk of developing keloid scars, such as:
- Age:People ages 20 to 30 have an elevated risk of keloid scars.
- Personal or family history of keloids:If one has developed one keloid, there is an increased risk of developing additional ones. Keloids may have a genetic component as they can be hereditary, suggesting a potential inherited tendency.
- Having brown or Black skin:Although the cause for this is unknown, individuals with brown or Black skin are more prone to keloids.
- Ethnicity: Individuals with a higher likelihood of developing keloid scars include those of South Asian, Chinese, African Caribbean, or Black African descent.
Diagnosis
The diagnosis of a keloid scar involves visually examining the affected area.
However, in certain cases where there is uncertainty or a need to eliminate the possibility of skin cancer, a skin biopsy may be recommended.
Treatment
While it is not possible to completely eliminate a keloid scar, various treatments can enhance its appearance and alleviate irritation. Surgical removal is generally discouraged as it often results in the keloid returning and potentially growing larger.
Keloid scar treatments encompass a range of options, and the most suitable approach may involve a single method or a combination of them. Common treatment options include:
- Wound treatment:Compression dressings are typically advised to be worn for 12 to 24 hours daily over a period of 4 to 6 months, as part of the initial treatment for recently formed keloids. Compression dressings are crafted from elastic fabrics or alternative materials. This approach is also applied post-surgery for keloid removal with the aim of minimizing or preventing scarring by applying pressure to the healing wound.
- Corticosteroid cream:Itching may be reduced by using a prescription-strength corticosteroid cream.
- Injected medication:Monthly keloid injections of cortisone or other steroid may be recommended for up to six months. This medication can help reduce the thickness or flatten the scar. Potential side effects include skin thinning, spider veins, and permanent changes in skin color.
- Cryotherapy:Freezing small keloids with liquid nitrogen could potentially reduce or eliminate them, with the possibility of needing repeat treatments. Potential side effects of cryotherapy include blistering, pain, and a loss of skin color.
- Laser treatment:The therapy typically involves multiple sessions spaced 4 to 8 weeks apart. Combining laser therapy with cortisone injections may also be recommended. Pulsed-dye laser sessions can flatten larger keloids, and this approach has proven effective in relieving itchiness and promoting keloid fading. Potential side effects, especially in people with darker skin, may involve changes in skin color and the development of blisters and crusts.
- Radiation therapy:This treatment can assist in reducing or minimizing scar tissue. Multiple treatments using low-level X-ray radiation may be recommended either independently or following surgical removal of a keloid. However, the risk of long-term effects such as cancer, and skin complications are among the potential side effects.
- Surgical excision: Surgery results has a recurrence rate ranging from 45% to 100%. Surgical removal in conjunction with other methods is typically recommended if the keloid has not shown improvement with other treatments.
