Keloids are a type of exaggerated scar that forms when scar tissue grows out of control. Unlike regular scars, keloids keep growing well after injury and do not regress over time. Keloids are smooth on top and range in color from pink and red to purple. Keloids can affect any part of the body. They do not pose a hazard to one’s health, although many people find them itchy or uncomfortable, and aesthetically unappealing.
A raised area of skin
Keloids are raised, and they often grow in claw-like masses across the skin, varying in color. Keloids are skin-colored, pink, red, purple, or brown. They form smooth, hard growths that can occasionally compromise movement based on their size and location on the body. Over 65 percent of keloids are found on the shoulder, chest, stomach, and earlobes Keloids occur 15 times more frequently with darker-skinned people—of African, Asian, and Latino descent—than with Caucasian people of European descent. Also, about 80 percent of all people affected by keloids are under the age of 30.
Scar tissue that grows larger over time
Unlike the average scar, keloids grow bigger over time. Experts are not certain about the cause of keloids, but there is speculation that it is due to altered cell signals connected to proliferation and inflammation. Also, unlike the average scar, keloids are unpredictable. Sometimes they do not appear until well after injury, and sometimes they start from minor inflammation, like an acne pimple, a burn, or a piercing.
Keloids form within scar tissue and cause changes to the skin including stretching of the skin, which often results in itching. This can be further irritated if the keloid is in a place on the body where it is in constant contact with clothing or other irritants.
Treatment varies greatly depending on the age of the patient and the severity of the scar. Corticosteroid injections are a common treatment for keloids. The injection is safe but can be painful. For keloid treatment, injections are commonly given once every 4-6 weeks. The purpose of the corticosteroids is to stop the proliferation of the keloid scar and to flatten it. The corticosteroid injections do have a few side-effects. They may make the skin very red, which can be corrected with laser treatment once the steroid treatment is complete. These injections can also cause the skin around the injection to become thin and sensitive.
Laser treatment can help to flatten and lighten the scar. Treatments are safe but costly, and usually, require multiple visits to achieve the desired effect. Treatments such as these are generally not covered by health insurance, so many people opt not to receive laser therapy.
Surgery is the most common but may be the least productive way to get rid of a keloid scar, because, in 70-100% of cases, the keloid grows back even bigger than before—especially if it is the solitary form of treatment. The chances of the keloid growing back reduce if surgery is combined with other forms of treatment including steroid injections, pressure therapy, laser therapy, or radiation therapy. Thus far, pressure therapy following surgery has shown the most success in inhibiting regrowth of the keloid.
Silicone gel or sheets
The effectiveness of silicone treatment for keloids has not been proven. However, patients have seen success in their treatment using silicone gel or silicone sheets. People believe these sheets flatten, reduce thickness, and neutralize the color of keloids. One major downside of silicone treatment is in its maintenance. Silicone sheets can be irritating and bulky, and they need to be on the skin to see results constantly. Silicone gel can take a long time to dry, and so the patient will need to refrain from covering or touching the area.
Cryotherapy, or the use of very low temperatures for treatment, has shown success in reducing keloids. Cryotherapists use special equipment to apply extreme cold to the keloid, destroying the keloid tissue. According to the Keloid Research Foundation, this method is the safest and results in the least chance of recurrence.