Am Fam Physician. 2009;80(3):online
See related article on keloids.
What are keloids?
Keloids (KEY-loids) are raised, red scars that are caused by excessive healing of skin wounds (for example, burns, cuts, acne). They can also occur after piercings, tattoos, or surgery. Many are itchy and painful. Sometimes they can cause emotional distress. Keloids can grow for years and sometimes show up three months or longer after the injury happened.
What causes them?
After a skin injury, your cells try to repair the damage by forming a scar. This scar holds the wound together. In some people, the scar keeps forming long after the wound heals.
How do I know if I am more likely to get them?
People with darker skin, such as black, Hispanic, and Asian people, are 15 to 20 times more likely to get keloids. But, some people with lighter skin also get them. Keloids are more common in people younger than 30 years, in pregnant women, and in teenagers going through puberty. People with a family history of keloids are also more likely to get them. Certain areas of the body are more likely to scar than others. Keloids usually occur on the chest, shoulders, earlobes, and cheeks.
How can I prevent them?
If you are more likely to get keloids, you should avoid skin injuries, ear piercing, and surgery whenever possible. If you need surgery, especially in an area that is more likely to scar, make sure your doctor knows that you may get keloids. Starting some treatments (for example, corticosteroid shots, pressure dressings) right after surgery may help to prevent keloids. If you get your ears pierced, you should wear pressure earrings to reduce scarring.
How are they treated?
There are many treatments for keloids, but no one treatment works for everyone. Talk to your doctor about which option is best for you. Common treatments include corticosteroid shots that can reduce the scar, freezing the scar, and silicone sheets worn over the scar. Sometimes, laser therapy can help. Some of these treatments are expensive and take time to work. Larger keloids can be removed with surgery, and treatment with shots and silicone sheets can help keep them from coming back.