I remember a patient coming into my clinic, clearly distressed. “It started as just a small cut on my chest,” he said, “and now… it’s this.” He pointed to a firm, shiny, raised scar that had grown far beyond the borders of the original little wound. It was itchy, sometimes tender, and it made him feel incredibly self-conscious. What he was describing is something we see quite often: a Keloid scar.
It’s a perfect example of the body’s healing process going into overdrive. When your skin is injured, your body rushes to produce a protein called collagen to mend the area. It’s a fantastic system. But sometimes, the body doesn’t get the “stop” signal and keeps making collagen, causing the scar to grow and rise above the skin.
What Is a Keloid Scar, Really?
Think of a keloid as an over-enthusiastic scar. Instead of just filling in the wound, it builds a mound that can be much larger than the initial injury. They tend to develop slowly, sometimes taking months or even years to fully form after the skin was first damaged.
And they can pop up anywhere, but we most commonly see them on the:
- Chest and back
- Shoulders
- Earlobes (from piercings)
- Jawline
The key thing to know is that these scars are benign—they aren’t cancerous or harmful to your physical health. But, of course, that doesn’t mean they don’t affect your life.
What Does a Keloid Look and Feel Like?
Every keloid is a little different, but they generally share a few characteristics. You might notice:
- Appearance: They can be pink, red, or darker than your natural skin tone. They’re often smooth and shiny but can sometimes be lumpy or ridged.
- Sensation: While the scar is actively growing, it can be quite itchy, tender, or even have a burning sensation. This discomfort usually lessens once the scar stops growing.
- Texture: They can feel soft and doughy or hard and rubbery.
- Growth: The defining feature is that they grow beyond the original wound’s boundaries.
What Causes a Keloid Scar?
Any kind of skin trauma can potentially trigger a keloid in someone who is prone to them. We don’t know the exact reason why some people’s bodies react this way, but we know what can set it off:
- Cuts, burns, or surgical incisions (like from a C-section)
- Severe acne or chickenpox
- Ear piercings or tattoos
- Even insect bites or shaving nicks
Some people are simply more likely to develop them. We see a strong genetic link, meaning if your parents or siblings get them, you might too. They are more common in people with darker skin tones and often appear between the ages of 10 and 30, a time when growth and hormones are very active.
How We Diagnose and Treat a Keloid Scar
Diagnosing a keloid is usually straightforward. I can typically tell just by looking at the scar and hearing your story about how it developed. Very rarely, if there’s any uncertainty, we might do a skin biopsy, where a tiny piece of the scar is removed and looked at under a microscope to rule out other things.
Now, for the important part: what can we do about it? The goal of treatment is to flatten, soften, or shrink the scar. It’s important to be patient, as it often takes a combination of therapies and time to see results. There’s no one-size-fits-all solution.
| Treatment Option | How It Works | A Doctor’s Note |
|---|---|---|
| Corticosteroid Injections | We inject a steroid directly into the scar to reduce inflammation and break down collagen fibers. | This is often our first step. It requires a series of injections every 4-6 weeks. It can be a bit uncomfortable, but it’s very effective at softening and flattening scars. |
| Cryotherapy | This involves freezing the scar with liquid nitrogen to damage the tissue and stop its growth. | This works best on smaller keloids. It can sometimes cause the skin to lighten in the treated area. |
| Laser Therapy | A pulsed-dye laser can help reduce the redness and flatten the keloid over several sessions. | This is a good option for improving the color and texture, but it’s often used alongside other treatments like injections. |
| Silicone Sheets or Gels | Applying these over the scar for several hours a day can help hydrate the skin and reduce scar formation. | This is a great, non-invasive option, especially for preventing a new wound from becoming a keloid. It takes a lot of consistency! |
| Surgical Removal | The keloid is surgically cut out. | We approach this with caution. Why? Because the new surgical wound can trigger an even larger keloid. We almost always follow surgery with other treatments like injections or radiation to prevent recurrence. |
Can I Prevent Them?
Unfortunately, you can’t completely prevent keloids if you’re genetically predisposed. But you can absolutely reduce your risk. If you know you have keloid-prone skin:
- Be extra careful to avoid unnecessary skin trauma. Think twice about elective cosmetic surgeries, piercings, or tattoos.
- If you get a cut or burn, treat it immediately. Keep it clean and covered.
- After a wound has closed, ask your doctor about using silicone gel sheets or pressure dressings. These can make a huge difference in how the scar heals.
Take-Home Message
- A Keloid scar is a raised scar that grows beyond the original injury due to excess collagen production.
- They are not medically dangerous but can cause itching, pain, and emotional distress.
- Treatment aims to reduce the scar’s size and improve its appearance; it often requires multiple approaches and patience.
- If you know you’re prone to keloids, take extra care with any skin injury to help prevent them from forming.
- Never try to treat or remove a keloid at home. Always talk to a healthcare provider to find the safest and most effective plan for you.
Living with a prominent scar can be tough on your self-esteem, and it’s okay to feel that way. The good news is that we have many ways to manage them.
You’re not alone in this, and we’re here to find a path forward together.
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