Signs and symptoms of keloids

Almost no one gets through life without at least a couple of scars – maybe you can trace yours back to when you first learned how to ride a bike, or perhaps you have one from when you had a C-section; a proud reminder of your body’s achievements.

Scars form as part of the body’s natural healing process after the skin has been cut or injured. In order to close open wounds and prevent infection, the body forms new collagen fibers that pull together the skin and mend the damage. The end result is a new patch of fibrous tissue covering the area where the original wound occurred.

Keloid scars come from an overgrowth of scar tissue due to an aggressive healing response to a wound or injury. Despite their alarming appearance, keloids are benign, meaning that they are not harmful to your health. However, they can cause quite a lot of emotional distress, especially if they are large or visible to others.

Why Do Keloids Form?

No one knows exactly why some people are more likely to develop keloids than others, but evidence suggests that folks of Asian, African, and Hispanic descent have a higher risk of developing them when they scar. In most cases, keloids form after an injury to the skin, such as a cut, scrape, burn, or surgical incision, although getting a piercing or a tattoo can also sometimes trigger a keloid formation.

One distinguishing characteristic of keloids is that they almost always grow far beyond the margins of the original wound. This happens because the body accidentally sends too many collagen cells to the wound site, which causes the scar to keep growing even after the injury has healed. In rare cases, it’s also possible for keloids to form on uninjured skin, typically around the mid-chest area. These are called “spontaneous keloids,” and scientists believe they may be caused by microtrauma or microscopic inflammation in the skin.

Other types of injury that can contribute to keloid scarring include:

• Acne scars
• Vaccination sites
• Chickenpox scars
• Wearing tightly braided hairstyles
• Hair removal
• Insect bites

Signs and Symptoms of Keloids

Keloids are relatively easy to identify. You may have a keloid scar if you notice the following signs and symptoms:

• A red, pink, or flesh-colored, raised scar
• A ridged or lumpy area of skin directly on top of a wound or injury site
• The area continues to grow (sometimes rapidly) beyond the margins of the original wound site
• Feels hard, firm and rubbery or soft and doughy to the touch
• It may feel tender, itchy, or painful
• The area gets easily irritated or chafed from rubbing against clothing or other forms of friction
• The scar gradually changes color until it ends up looking darker than the surrounding skin, especially if exposed to the sun within the first year after it forms

Keloid scars can appear anywhere in the body, but they are most common in the following parts of the body:

• Ears
• Chest – relatively common in at-risk individuals after coronary bypass surgery
• Shoulders
• Neck
• Back
• Arms

A dermatologist or reconstructive plastic surgeon with experience treating scars and benign growths can diagnose keloids by looking at your skin. In some cases, they may also order a skin biopsy to rule out harmful tumors.

Treatment and Long-Term Outlook

Keloids are notoriously difficult to treat because they often grow back – sometimes even larger – after removal. For this reason, doctors usually treat keloids by using a combined approach of several different methods. Treatment options include:

Silicone gel pads: if the keloid is relatively new, your doctor may recommend silicone-based patches that help flatten and reduce the size of the scar.

Compression therapy: also appropriate for newer keloids, it involves wrapping the scar with surgical gauze to reduce blood flow to the area. Pressure dressings must be worn for 16-23 hours a day every day for at least six months to achieve the desired outcomes.

Creams and ointments: prescription lotions containing vitamin E and onion extract can help reduce the appearance of small keloids when combined with other approaches.

Cryotherapy: appropriate for smaller keloids, this treatment involves applying freezing temperatures to the keloid scar to flatten the area.

Intralesional injections: corticosteroid injections can be used to break collagen bonds and shrink small to medium keloids. A typical treatment plan involves multiple injections administered every three to four weeks.

Surgical excision: typically reserved for large keloids, surgically removing the keloid scar can provide temporary relief, but this intervention does have a high recurrence rate if not combined with other treatments, such as superficial radiation therapy.

Superficial radiation therapy (SRT): after the keloid has been surgically removed, applying low-dose radiation can help destroy keloid-forming cells to keep them from coming back. Undergoing SRT after surgical excision can lower the rates of recurrence from 50-90% to 5-10%.

Reduce the Appearance of Keloids With a Personalized Treatment Plan

There is no one-size-fits-all approach for improving the appearance of keloid scars. Since keloids are stubborn and typically come back even after surgically removing them, it is important to approach them on a case-by-case basis. If you have a keloid that’s bothering you, the experts at The Keloid Plastic Surgery Center can provide you with the personalized care that you need. Call 1 (833) 4KELOID or 1 (305) 440-1806, or click here to schedule an appointment today.