Are You At Risk for Keloids?

Why Do We Get Scars?

Scars are the body’s way of healing an injury caused by a scrape, cut, burn, or another type of wound and are the fibrous tissue left behind on the skin once the damaged tissue has healed. While the skin tissue is damaged, the body repairs the injury by increasing production of collagen at the wound site. The fibrous tissue that appears over the wound also protects it from further injury. Normal scars will develop and then heal with redness or discoloration but will eventually fade over time. But some individuals are susceptible to a more disfiguring type of scar.

What Makes Keloids Different?

A keloid is a scar that appears with an abnormal healing response to injury or trauma.

It is similar in appearance to hypertrophic scars which are also raised, but unlike hypertrophic scars, which develop within the boundaries of the wound and will diminish with treatment, a keloid also can grow beyond the primary site of injury and once formed becomes permanent.

A keloid has a hard, smooth surface and an irregular shape that can range from a small worm-like growth to a large disfiguring scar. It can be pinkish red to purple, nearly black in color. The skin surrounding the keloid might also darken or turn gray and can grow larger than the actual wound itself.

Who Gets Keloids?

Anyone can get keloids. Keloids can affect all races and all skin types, but some individuals are more prone to developing them. They are more expected to occur in people under 30 (usually between ages 10 – 20) and individuals of African descent, Asians, and Hispanics. Keloids also seem to run in families.

Why Do Keloids Form?

Keloids typically appear on the chest, back, shoulders, earlobes, and sometimes on the jawline.

There is still not a lot known about why keloids form. It’s not even known if or when keloids will develop. Keloids can also take from a few days, weeks to a year to develop.

One could have a keloid form after an injury, yet a keloid might not form at the site of another injury. Since keloids usually form before the age of 30 and then either decreased or stop forming as one gets older, it is thought that there might be a hormonal connection. An increased problem in black skin is also thought to be due to larger fibroblasts, which are the cells in the dermal layer of the skin responsible for making collagen. When the wound heals, the skin produces more collagen than needed, leaving excess scar tissue.

There doesn’t seem to be a definite, proven keloid treatment. There are so many factors involved in the formation of keloids, and the treatment depends on the individual, size, and dimension of the scar, how old the scar is, as well as placement of the scar.

In some cases, keloids can grow large, be painful and itchy, or if one isn’t careful, can become infected. In more serious cases keloids can cause problems if they form on or around the joints and interfere with the range of motion.

Things That Can Cause Keloids

• Injury or trauma – cuts, scrapes, burns, nicks from shaving, waxing, plucking hairs, tattoos, ear and other body piercing.
• Skin conditions that can cause scars like chicken pox, acne, and surgery. Sometimes acne can become more disfiguring than the acne itself and often cosmetic surgery or surgery to remove keloids can cause additional scarring.

Acne & Skin of Color

Keloid Treatment

The following are typical treatments for shrinking, removing and preventing the recurrence of keloids:

• Cortisteroids – To reduce or flatten the scar, a dermatologist might perform a series of Cortisone injections into the keloid. Cons: Infection can develop at the injection site, and the scar may become lighter in color than the skin in the surrounding area.
• Surgery – The keloid is surgically removed. Cons: Surgery is tricky because another keloid could form after surgery and it could be even larger than the original wound. To help prevent this, the surgeon might inject steroids or apply pressure dressings to the wound site post surgery.
• Laser Surgery – Laser surgery is used to flatten the keloid. Cons: Several treatments might be needed, and this could be costly. Lasers too pose a risk of inflammation, further scarring, and hyperpigmentation.
• Compression Therapy – Pressure is applied to the wound with a compression bandage, pressure earring for earlobe keloids or a compression garment to help prevent the recurrence of keloidal scars.
• Silicone Sheets – Silicone sheeting and gel can be applied to the keloids and then covered with microporous tape or Steri-Strips (adhesive strips) to keep it in place, for several hours (usually applied at night) for a few weeks to months, to flatten the scars. Cons: Only effective on newly formed scars.
• Cryotherapy – Cryotherapy might be used to freeze the keloids to flatten them and kill skin cells. Cons: This can darken the area of treatment.
• Interferon injections – Interferon injections are used to reduce the size of keloids. Interferons are proteins originated by the body’s immune system to fight off viruses bacteria and pathogens. Cons: This might not be lasting.
• Aldara Cream – Aldara is a topical imiquimod cream and an immune response modifier that enhances healing to prevent keloid recurrence after surgery by stimulating the body to produce interferon.
• Radiation – Low-dose radiation therapy is used with other treatments such as surgery and pressure treatments to prevent the development of keloids or to keep keloids from returning. Con: This is a very controversial and last resort method for those that are known to develop severe keloids because of other dangers, such as a risk for developing skin cancer.

Since keloids are difficult, and some say, impossible to completely remove once they have formed, it is important to take steps to prevent the scars from forming.

Related

• 11 Natural Ways to Prevent Keloids