Keloid Treatment, Symptoms, and Causes

A keloid is a smooth, raised scar that is generally larger than the original injury and darker than the surrounding skin. An estimated 10% of people will experience keloid scarring. Due to their raised appearance, they are some of the most conspicuous types of scars, which might pose a challenge to minimize. In this article, we will discuss keloid treatment options, what they usually look like, as well as their causes.

What is a keloid?

Keloids form when there is an overgrowth of fibrous tissue (scar tissue) on the skin, presenting itself as a raised scar. When the skin tissue is damaged, scar tissue will develop above the wound to repair the injury. 

What do keloids look like? How do I know if I have a keloid? 

Credit: American Academy of Dermatology Association

Keloids may vary in shapes and sizes. If it’s on the earlobe, it mostly presents itself as a round, solid mass. When it develops on the shoulders or chest area, the keloid is likely to be spread out across the skin. To identify a keloid, they usually feel painful or itchy and begin as a pink, red or purple scar raised above your skin. In some cases, if this scar covers a large area on the body, it may decrease an individual’s mobility at that certain body part.

Once you see a keloid, it tends to grow slowly. Most continue to spread for weeks and months. They can become increasingly irritated, itchy or painful when rubbed against your clothes. Additionally, keloids may become darker with time – the border is usually darker than the center.

How do people get keloids? 

Keloids are classified as a type of tumor, but not malignant. Surprisingly, they can develop from the most common types of skin injuries such as acne scars, burns, chicken pox scars, piercings, vaccinations as well as surgical incision areas. Keloid scarring can also stem from genetic factors, which means a child has a higher risk of getting it if either parents have them. They are also more likely to develop on people of darker skin colours as compared to those with lighter skin tones. Therefore, researchers believe that this scarring may be linked to a gene related to dark skin pigment. 

Keloids on a man’s chest. These keloids appeared slowly after severe acne cleared.
Credit: American Academy of Dermatology Association

Keloids vs Hypertrophic scars

It is not uncommon that some people confuse keloids with hypertrophic scars. Unlike keloids, hypertrophic scars are smaller and flatter, and the colours can range from pink to brown. They can also fade or go away over time, but keloids are not able to. Causes of hypertrophic scars are similar to keloids, such as piercings. Initially, they can be itchy and painful but symptoms will alleviate as the skin heals. 

Do keloids go away? What are the keloid treatment options available?

Unfortunately, keloids are considered quite difficult to get rid of and even if they are treated, there are chances of them resurfacing again. However, the success of keloid treatment can vary, and it is advisable to seek a dermatologist to help develop a treatment plan to best suit the removal of keloid scarring. 

Steroid Injection or Cream

These are also known as intralesional injections, which involves injecting steroids directly into the scar tissue in order to reduce its size. This keloid treatment method is one of the more common approaches, however, it is important to note that 50-80% of keloids reform after this treatment. Steroid creams are also an alternative. According to studies, there is a 9-50% chance of the scar resurfacing. 

Cryotherapy

Cryotherapy, also known as cryoablation, refers to the use of extreme cold to freeze and remove abnormal tissues. This treatment method involves freezing off a keloid scar, and is generally more successful for smaller scars.

Surgery and Radiotherapy

Surgery is usually the last resort for keloids treatment, mainly because it may cause a larger scar to develop. Radiotherapy can aid in decreasing the size of the scar and also produces much better results if it occurs after surgery. 

SRT-100TM

This keloid treatment is non-abrasive and is a type of superficial radiation therapy and is significantly effective in getting rid of keloid scarring, with a success rate over 90%. Performing surgery will still lead to keloids growing back eventually but with the SRT-100TM, there is a less than 10% chance of the regrowth. The mechanism behind this is that keloid cells are destroyed, which allows low chances of resurfacing. Due to its high success rate, it has been described as The Keloid Cure and is also approved by the FDA. 

Prevention of Keloids 

Prevention methods include avoiding piercings, cosmetic surgeries and tattoos and adopting proper wound care habits. Practice proper wound care by washing the injured skin area immediately using soap and clean water, followed by using a sterile gauze to cover up and bandage the affected area. Do visit an accredited dermatologist, for advice on your keloid scarring. 

Have a keloid concern? Book a TeleConsultation, with MOH accredited dermatologist, Dr. Teo Wan Lin, to have your condition addressed. Click on bottom left button to contact us or simply click here to book an appointment now.

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