What is a keloid scar? A keloid is an abnormally formed scar. Scars happen when your body repairs any type of skin wound. Skin cells and connective tissue cells (fibroblasts) multiply and form a patch of tissue to bridge the the wound. Usually, scars end up being slightly thicker, pinker and shinier than your normal skin. Then, they fade with time. Keloid scars are raised and thick. They are also often firm and discolored compared to the rest of your skin. Sometimes, a keloid scar causes itching, pain or tenderness. Keloid scarring develops when fibroblasts do not stop multiplying once the wound has healed. The scar continues to grow and spread, often covering an area larger than the original wound. Basically, the scar grows into a benign, or noncancerous, tumor. This process usually happens slowly with time. Keloid scars can take several months or longer to appear after a wound heals. Approximately 10% of people form keloid scars. Doctors don’t fully understand why some people are more prone to them than others. However, they know keloid scarring is more common in people with dark skin pigment. It also tends to run in families. Keloid scars can be difficult to treat. Multiple treatment approaches are usually necessary. This may include injections, laser therapy, freezing or cryotherapy, and silicone sheets. Surgical shaving is sometimes an option. Pressure dressings after surgery help reduce the risk of the scar returning. Keloid scars do not pose a health risk. However, you should see your doctor if a keloid scar is bothering you. In some cases, doctors can cure the scar. However, recurrence is very common. If cure is not possible, treatment can improve the look and feel of the scar without totally eliminating it. If you are prone to keloid scarring, using pressure dressings on wounds may help prevent scars from developing. What are the symptoms of a keloid scar? Keloid scars tend to develop and grow slowly. It can take a few months, or even longer than a year, for a keloid scar to appear. The proliferating scar may continue to grow and spread for weeks, months or years. However, it is possible for a keloid scar to grow and spread very quickly. They range in size from small dots to large growths of 12 inches or more. They most commonly appear on the ears, face, neck, shoulders, upper back, and chest. Scars on the upper trunk tend to be the largest. Common symptoms of keloid scars Common keloid scar symptoms include: Pain, itching or tenderness. Large scars can also limit movement of the affected body part. Pink, red or purple color. The scar is usually darker than a person’s normal skin tone. It may continue to darken with time and sun exposure. Raised skin surface that feels different from surrounding skin. The raised area is usually fixed in place, meaning you can’t move it. Larger keloids can restrict movement. Soft, rubbery or hard texture If you notice a scar developing abnormally, see your doctor. While it doesn’t pose a health risk, a keloid scar can adversely affect your self-esteem and quality of life. They will not go away on their own, but may respond to treatment. A referral to a dermatologist may be necessary to effectively manage the problem. What causes a keloid scar? Normally, your body responds to a skin wound by laying down new skin cells and connective tissue cells called fibroblasts. The resulting scar is usually somewhat thicker, pinker and shinier than the rest of your skin. A keloid scar occurs when fibroblasts continue multiplying after the healing is complete. Any type of skin wound can result in a keloid scar. You can develop a keloid scar from acne or other minor wounds. You can also end up with a keloid scar from a C-section or other surgical wound. Keloid scars can even develop after tattooing or ear or body piercing. There is also a type of keloid scar called a spontaneous keloid. This scarring develops on uninjured skin for no apparent reason. They most commonly appear on the chest and affect people with a higher risk of developing keloids. What are the risk factors for a keloid scar? Keloid scars occur in about 10% of the population. It is unclear why some people develop keloid scars and others do not. However, several factors increase the risk of developing them. Risk factors for keloid scars include: African, Asian, Hispanic or Latino descent. The risk is 15 to 20% higher in these groups with darker skin tones. Age between 10 and 30 years Family history of keloid scars. About 1 in 3 people with keloids have a parent, sibling or child who also has them. There may also be a link between sex hormones and keloid scars. Research suggests a higher incidence of keloid scarring during puberty and pregnancy. In women, keloid scars tend to shrink in size after menopause. Reducing your risk of keloid scars There are steps you can take to help prevent keloid scars. You may be able to lower your risk of developing a keloid scar by: Avoiding piercings and tattoos. If you notice the skin thickening around an ear piercing, wear a pressure earring. Using this device for up to six months may prevent a keloid scar if you start it soon enough. Protecting bites, cuts, and other wounds from the sun with bandages or clothing while the wound heals. After healing, use SPF 30 or higher sunscreen daily. Treating wounds right away by gently washing the wound daily, applying a thin layer of petroleum jelly, and covering with a sterile bandage. Use first-aid tape to apply constant and even pressure on the wound. Using a silicone gel sheet to cover the wound after it has healed completely. Wear the sheet for 12 to 24 hours a day for three months. Using pressure dressings and garments after surgery If you know you are at risk of developing keloid scars or have already had one, work with a dermatologist. There may be specific products and dressings your dermatologist recommends to manage wounds and prevent keloids. How is a keloid scar treated? Keloids are notoriously hard to treat. There is also a high recurrence rate when doctors remove keloid scars. Often, the goal of treatment is to relieve symptoms and improve the look and feel of the scar. Doctors typically use two or more of the following keloid scar treatment options: Corticosteroid injections can shrink and soften the scar. This approach requires a series of shots over several weeks or months. Up to 80% of keloids will respond, but many will regrow within five years with this treatment alone. Sometimes, doctors add a chemotherapy drug to the injection for resistant cases. Cryotherapy—or freezing—can reduce the size and hardness of the scar. For best results, a series of three treatments is usually necessary. It usually works best on small keloids in combination with corticosteroid shots. Laser therapy can flatten and lighten the color of a keloid. Radiation therapy can reduce the size of a keloid. However, doctors most often use it after surgery to prevent the keloid from returning. It is effective in about 85% cases. Silicone gel sheets may help flatten a keloid. You may need to use a silicone sheet for six months or longer to see results. Surgery to cut out or shave off the keloid. Almost all keloids will return after surgery. To reduce the risk of recurrence, doctors use pressure treatments after surgery. Pressure dressings and garments are effective in 90 to 100% of people who use them diligently. This requires wearing the device for up to 16 hours a day for up to a year. What are the potential complications of a keloid scar? Keloids are not a risk to your physical health. However, they can take a toll on your emotional health and quality of life. This is especially true for scars on the face and large scars that are disfiguring. Seeking treatment can help improve the appearance of the scar, even if it does not totally get rid of the scar. Even when treatment successfully eliminates a scar, there is a high chance of it returning. For the best results, find a dermatologist with plenty of experience treating keloid scars. Then, follow your doctor’s treatment instructions closely.