Table of ContentsView AllTable of ContentsRisk FactorsCausesPreventionTreatment
Table of ContentsView All
View All
Table of Contents
Risk Factors
Causes
Prevention
Treatment
Keloidscarsare defined as abnormal scars that are hard, smooth, and grow beyond the boundary of the original skin injury. The scar is a raised and ill-defined growth in the area of damaged skin, and it can cause pain, itching, and burning.
This article covers why keloid scars form and who is more likely to develop them. It also discusses several ways this type of scar can be treated, along with what you may be able to do to prevent them.
This photo contains content that some people may find graphic or disturbing.See PhotoReproduced with permission from © DermNet New Zealandwww.dermnetnz.org2023.
This photo contains content that some people may find graphic or disturbing.See Photo
This photo contains content that some people may find graphic or disturbing.
Reproduced with permission from © DermNet New Zealandwww.dermnetnz.org2023.
Although a keloid scar can form on anyone, some ethnic groups are at a greater risk. People with more melanin in their skin, such as Black people, Asians, and Hispanics, are more susceptible.
Keloid scars are seen 15 times more frequently in highly pigmented ethnic groups than in White people. The scars are very rarely seen in people withalbinism.
Some areas of the body are more prone to keloid scars, particularly parts where there is skin or muscle tension. This includes thedeltoidregion of the shoulder`, the upper back, and thesternum(breastbone).
Theearlobesand the back of the neck are also common sites. Very rarely do keloids form on the eyelids, genitals, palms, or soles of the feet.
It is not fully understood why or how keloid scars form.Skin trauma appears to be the most common cause, although scars can also form for no apparent reason.
Infection at a wound site, repeated trauma to the same area, or a foreign body in a wound can also be factors. There does appear to be a genetic factor to keloid scarring as well. If someone in your family has keloids, then you are at increased risk.
Another theory for why keloids form involvescollagen—the major protein in your skin that keeps it strong and supple. Collagen plays a vital role in wound healing and scar formation. It’s thought that an imbalance of collagen production can affect the wound healing process and contribute to keloid scars.
Work is being done to identify the exact causes of keloids. Knowing precisely what causes them will likely lead to better preventive medicine and more effective treatments in the future.
If you know you are prone to keloid scars due to previous experience or a family history of them, then you can take extra precautions to avoid wounds.Do not get piercings or tattoos. If you are going to have surgery, let your healthcare provider know that you are more susceptible to keloid scarring.
Some healthcare providers say that all highly pigmented people should avoid tattoos and piercings, just to be on the safe side.
How to Prevent or Minimize Surgery Scars
Keloid scars can be removed with surgical treatments, non-surgical treatments, and combinations of the two.
Surgical Treatment
Surgical removal of keloid scars has a very high regrowth rate, anywhere from 50% to 100%.Laser therapyhas been tried as an alternative to knife surgery but so far the outcomes are no better.
After scarexcision, a silicon gel or sheeting should be applied immediately to the excision site and used daily for six to nine months. The gel is clear and makeup can be applied over it.
If the keloid seems to be reappearing after surgery, a steroid such as triamcinolone can be injected into the lesion to keep the keloid from growing back. The injections are given every four to six weeks as needed.
How Anabolic Steroids and Corticosteroids Differ
Non-Surgical Treatments
Interferon therapy (medication acting on theimmune system) has been reported as effective in reducing keloid scarring. However, it can have some significant side effects, including:
Prolonged compression of scar tissue may help soften and break up keloid scars, but the practicality of this option depends on the location of the keloid.
Other non-surgical interventions that are currently being tried with varying results include:
Combined Treatments
Because surgery alone is not very effective, healthcare providers can remove the scar and then provide steroid injections. One injection is given at the time of the surgery and a second injection is given about a month later.
However, scars are reported to recur after this type of treatment in about 50% to 70% of cases.
Another option combines surgery with radiotherapy. Radiation interferes with skin growth (specifically cells called fibroblasts) and collagen production. Research varies on which type of combination therapy is more effective.
Both radiotherapy andsteroid drugshave side effects, so you need to discuss with your healthcare provider which treatment will be best for you. It may be worth getting a second opinion before proceeding with either treatment.
7 Dos and Don’ts for Getting Rid of Keloids
Summary
It is not entirely known why keloid scars form, but it is clear that people with darker skin and people with a family history of keloids are more likely to get them. If you are prone to keloids, the only way to prevent them is to avoid wounds as best as you can. While keloids can be treated with surgical removal or steroid injections, they are fairly likely to grow back.
A Word From Verywell
Keloids usually don’t require treatment, but speak up if yours cause a problem for you, whether it’s discomfort or embarrassment. Your healthcare provider can then work with you on what the best approach might be for getting rid of or at least minimizing your scar.
Overview of 3 Types of Surgery Scars
9 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Gao FL, Jin R, Zhang L, Zhang YG.The contribution of melanocytes to pathological scar formation during wound healing.Int J Clin Exp Med. 2013 Aug;6(7):609-613.American Academy of Dermatology Association.Keloids: signs and symptoms.Tsai CH, Ogawa R.Keloid research: current status and future directions.Scars Burn Heal. 2019 Aug;5(1):1-8. doi:10.1177/2059513119868659Betarbet U, Blalock T.Keloids: A review of etiology, prevention, and treatment.J Clin Aesthet Dermatol. 2020 Feb;13(2):33-43.University of Michigan Health.Keloid scars.Chua SC, Gidaszewski B, Khajehei M.Efficacy of surgical excision and sub-dermal injection of triamcinolone acetonide for treatment of keloid scars after caesarean section: a single blind randomised controlled trial protocol.Trials. 2019;20(1):363. doi:10.1186/s13063-019-3465-6Coppola MM, Salzillo R, Segreto F, Persichetti P.Triamcinolone acetonide intralesional injection for the treatment of keloid scars: patient selection and perspectives.Clin Cosmet Investig Dermatol. 2018 Jul;11(1):387-396. doi:10.2147/CCID.S133672Trisliana Perdanasari A, Lazzeri D, Su W, et al.Recent developments in the use of intralesional injections keloid treatment.Arch Plast Surg. 2014 Nov;41(6):620-629. doi:10.5999/aps.2014.41.6.620Jfri A, Alajmi A.Management of keloid scars: surgical versus medical therapy.J Dermatol Res Ther.2018;4(1):059. doi:10.23937/2469-5750/1510059
9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Gao FL, Jin R, Zhang L, Zhang YG.The contribution of melanocytes to pathological scar formation during wound healing.Int J Clin Exp Med. 2013 Aug;6(7):609-613.American Academy of Dermatology Association.Keloids: signs and symptoms.Tsai CH, Ogawa R.Keloid research: current status and future directions.Scars Burn Heal. 2019 Aug;5(1):1-8. doi:10.1177/2059513119868659Betarbet U, Blalock T.Keloids: A review of etiology, prevention, and treatment.J Clin Aesthet Dermatol. 2020 Feb;13(2):33-43.University of Michigan Health.Keloid scars.Chua SC, Gidaszewski B, Khajehei M.Efficacy of surgical excision and sub-dermal injection of triamcinolone acetonide for treatment of keloid scars after caesarean section: a single blind randomised controlled trial protocol.Trials. 2019;20(1):363. doi:10.1186/s13063-019-3465-6Coppola MM, Salzillo R, Segreto F, Persichetti P.Triamcinolone acetonide intralesional injection for the treatment of keloid scars: patient selection and perspectives.Clin Cosmet Investig Dermatol. 2018 Jul;11(1):387-396. doi:10.2147/CCID.S133672Trisliana Perdanasari A, Lazzeri D, Su W, et al.Recent developments in the use of intralesional injections keloid treatment.Arch Plast Surg. 2014 Nov;41(6):620-629. doi:10.5999/aps.2014.41.6.620Jfri A, Alajmi A.Management of keloid scars: surgical versus medical therapy.J Dermatol Res Ther.2018;4(1):059. doi:10.23937/2469-5750/1510059
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Gao FL, Jin R, Zhang L, Zhang YG.The contribution of melanocytes to pathological scar formation during wound healing.Int J Clin Exp Med. 2013 Aug;6(7):609-613.American Academy of Dermatology Association.Keloids: signs and symptoms.Tsai CH, Ogawa R.Keloid research: current status and future directions.Scars Burn Heal. 2019 Aug;5(1):1-8. doi:10.1177/2059513119868659Betarbet U, Blalock T.Keloids: A review of etiology, prevention, and treatment.J Clin Aesthet Dermatol. 2020 Feb;13(2):33-43.University of Michigan Health.Keloid scars.Chua SC, Gidaszewski B, Khajehei M.Efficacy of surgical excision and sub-dermal injection of triamcinolone acetonide for treatment of keloid scars after caesarean section: a single blind randomised controlled trial protocol.Trials. 2019;20(1):363. doi:10.1186/s13063-019-3465-6Coppola MM, Salzillo R, Segreto F, Persichetti P.Triamcinolone acetonide intralesional injection for the treatment of keloid scars: patient selection and perspectives.Clin Cosmet Investig Dermatol. 2018 Jul;11(1):387-396. doi:10.2147/CCID.S133672Trisliana Perdanasari A, Lazzeri D, Su W, et al.Recent developments in the use of intralesional injections keloid treatment.Arch Plast Surg. 2014 Nov;41(6):620-629. doi:10.5999/aps.2014.41.6.620Jfri A, Alajmi A.Management of keloid scars: surgical versus medical therapy.J Dermatol Res Ther.2018;4(1):059. doi:10.23937/2469-5750/1510059
Gao FL, Jin R, Zhang L, Zhang YG.The contribution of melanocytes to pathological scar formation during wound healing.Int J Clin Exp Med. 2013 Aug;6(7):609-613.
American Academy of Dermatology Association.Keloids: signs and symptoms.
Tsai CH, Ogawa R.Keloid research: current status and future directions.Scars Burn Heal. 2019 Aug;5(1):1-8. doi:10.1177/2059513119868659
Betarbet U, Blalock T.Keloids: A review of etiology, prevention, and treatment.J Clin Aesthet Dermatol. 2020 Feb;13(2):33-43.
University of Michigan Health.Keloid scars.
Chua SC, Gidaszewski B, Khajehei M.Efficacy of surgical excision and sub-dermal injection of triamcinolone acetonide for treatment of keloid scars after caesarean section: a single blind randomised controlled trial protocol.Trials. 2019;20(1):363. doi:10.1186/s13063-019-3465-6
Coppola MM, Salzillo R, Segreto F, Persichetti P.Triamcinolone acetonide intralesional injection for the treatment of keloid scars: patient selection and perspectives.Clin Cosmet Investig Dermatol. 2018 Jul;11(1):387-396. doi:10.2147/CCID.S133672
Trisliana Perdanasari A, Lazzeri D, Su W, et al.Recent developments in the use of intralesional injections keloid treatment.Arch Plast Surg. 2014 Nov;41(6):620-629. doi:10.5999/aps.2014.41.6.620
Jfri A, Alajmi A.Management of keloid scars: surgical versus medical therapy.J Dermatol Res Ther.2018;4(1):059. doi:10.23937/2469-5750/1510059
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
