Keloids occur as a result of abnormal healing of the skin following injury such as surgery, trauma and various skin conditions including chickenpox. Some keloids develop immediately, while others continue to grow over time. Keloids form when an overgrowth of fibrous tissue occurs outside the injury border producing a lumpy, misshapen tumor.
The abnormal scar tissue ranges in color from flesh-toned to pink or red and may be tender or itchy. When exposed to sunlight, keloids become darker than surrounding skin and this pigment change may be permanent.
Keloids are more common in individuals with darker skin tones and those with a family history of keloids. They develop most often between the ages of 10 and 20 years and can create cosmetic concerns. Keloids can mimic certain skin cancers. For this reason, it is advisable a dermatologist evaluate any abnormal scar.
Keloids can also be confused with hypertrophic scars, but there are differences between the two. Like keloids, hypertrophic scars are the result of excessive tissue growth but do not extend beyond the borders of the original injury as keloids do. Hypertrophic scars contain fewer thick collagen fibers than keloids and tend to improve with time, while fibroids often worsen.
Treatment of keloids is challenging but some therapies may reduce the tumor size. Options include: injecting the scar with corticosteroids, cryotherapy, laser treatment, radiation therapy, and applying silicone gel or patches. Surgical removal is also an option, but should be followed by additional treatment such as corticosteroid injections or silicone application to prevent new scars from forming.
If you are at risk of developing keloids, the following steps may aid in prevention:
- Avoid elective or cosmetic procedures
- Request necessary incisions be placed in skin folds and creases
- Ask that tension be reduced on sutures
- Protect recent injuries and scars from sun exposure
- Ask your dermatologist about using Imiquimod cream to prevent keloids from forming after surgery
Keloids are not harmful and require no treatment unless symptoms change or you wish to have them removed for cosmetic reasons.