Keloid Scars

Keloid scars are raised, thickened scars characterised by an overgrowth of dense, fibrous tissue. They often develop after the original skin injury has healed and can grow much larger than the original wound. Hypertrophic scars are also raised but stay within the boundaries of the original injury, while keloid scars can spread beyond the initial wound site, becoming much bigger with time.

They are typically smooth, hard, and rubbery in texture. Their colour can vary from pink or red to flesh-coloured or dark brown. They can be unsightly, uncomfortable, itchy and sometimes even restrict movement.

Keloids can develop after various types of skin trauma, including:

• Surgical incisions
• Piercings
• Tattoos
• Acne
• Burns
• Insect bites
• Vaccinations

The exact cause of keloid formation is not fully understood, but it is believed to be a result of an abnormal healing response. Several factors are thought to contribute:

• Genetics: There is a strong genetic predisposition to keloid formation. People with a family history of keloids are more likely to develop them.
• Skin Type: Keloids are more common in individuals with darker skin tones, such as those of African, Asian, or Hispanic descent. These ethnic groups have a higher incidence of keloids.
• Increased Collagen Production: During the wound healing process, the body produces collagen to repair the damaged skin. In keloids, there is an overproduction of collagen, leading to the excessive scar tissue.
• Inflammatory Response: An exaggerated or prolonged inflammatory response during the initial stages of wound healing may contribute to keloid development.
• Growth Factors: Certain growth factors involved in tissue repair may be overactive in keloid formation.
• Skin Tension: Areas of the body with high skin tension, such as the chest, shoulders, upper back, and earlobes, are more prone to developing keloids.
• Wound Characteristics: Factors like wound depth, size, and location can influence the likelihood of keloid formation. Infected or inflamed wounds may also be more susceptible.
• Hormonal Changes: Changes in hormones, such as those that occur during puberty or pregnancy, can also trigger keloid formation.

Keloid scarring can cause a variety of potential issues, depending on the nature of the scar and the individual:

• Cosmetic Concerns: The most common concern is the appearance of the keloid, which can be significantly different in colour and texture from the surrounding skin, leading to self-consciousness and psychological distress.
• Itching: Keloids can often be itchy, sometimes intensely so.
• Pain or Tenderness: Some keloids can be painful to the touch or cause a burning sensation.
• Restricted Movement: Large keloids located over joints can restrict movement and cause functional limitations.
• Psychological Impact: The visible nature of keloids can lead to anxiety, depression, and a negative impact on self-esteem and social interactions.

There are a number of potential treatment options:

• Surgery: Surgical removal of keloids can be highly effective in removing the overactive skin tissues. Often, surgery is combined with other treatments, such as corticosteroid injections or laser treatment.
• Laser Therapy: Laser treatments can help flatten and reduce the pigmentation of keloids. Different types of lasers may be used depending on the keloid’s characteristics.
• Cryotherapy: This treatment involves freezing the keloid tissue, which can help reduce its size and improve its appearance.
• Corticosteroid Injections: These injections help reduce inflammation and flatten the keloid over time. Multiple treatments may be necessary for optimal results.
• Silicone Gel: We recommend use of silicone gel after surgical removal. It can also be used to help prevent scar formation.
• Pressure Therapy: Applying constant pressure to keloids using specially designed garments may help reduce their size, but this may not be an option depending on where the scar is located.
• Alternative Treatments: Options such as herbal remedies and homeopathic treatments are available, though their effectiveness is often not scientifically validated and we would not endorse this option.

At Cosmedics Skin Clinics, our team sees the greatest success with surgical reduction of keloid scars. Our team is also able to offer laser treatment to reduce the scar or accelerate healing. We also offer cryotherapy and injections as appropriate, but tend to favour surgery as the most effective solution.

Preventing skin injury is the best approach to avoiding keloid scars. This includes:

• Taking care of cuts and injuries by keeping them clean and properly dressed to promote good healing.
• Taking extra care with piercings and tattoos.
• Prompt and proper treatment of acne and other skin conditions.
• Avoiding elective surgeries or cosmetic procedures if possible.
• Making healthcare providers aware if you’re prone to keloid scarring before any surgical procedures.
• Using pressure therapy or silicone scar gel on new wounds in high-risk area and minimising skin tension around wounds.

Keloid scars can indeed recur after surgical removal, although surgery is completely effective in most patients.

If you visit Cosmedics Skin Clinics for a consultation, our doctors/surgeons will do their best to provide honest information about the risk of recurrence based on their assessment of your skin and scarring.