Keloid

Keloids generally form after a skin injury heals. For unknown reasons, some people produce an excess of dense, fibrous tissue at and around the site of injury. A keloid is abnormal because the scar extends above and beyond the site of the original injury, whereas normal scars remain confined to the site of injury.

Keloids are thick, smooth areas of pink scar tissue. The scar tissue is raised above the level of the surrounding skin. Some keloids are itchy or tender. Keloids can occur on any skin area. The most common locations for keloids vary according to race. In Caucasians, for example, keloids are most common on the face and arms, while those with darkly pigmented skin more often develop keloids on the face and legs.

The exact cause of keloids is unknown. However, they run in families and are associated with certain abnormal genes.

The exact cause of keloids is unknown. They do run in families, however, and are associated with certain abnormal genes. Other risk factors for keloids include the following:

• age between 10 and 30
• Polynesian, Chinese, and black African ethnic backgrounds
• type A blood

Keloids are associated with skin healing after an injury. Some events associated with keloid formation include the following:

• accidental injuries
• piercing of body parts, such as the earlobes and abdomen
• surgery

Persons who tend to develop keloids should avoid cosmetic procedures to their skin. If surgery is necessary, an injection of cortisone can be made into the skin first. This may lower the risk of developing a keloid.

Keloids are diagnosed by their appearance.

Keloids may be cosmetically embarrassing. However, they cause no long-term health problems.

Keloids are not contagious and pose no risk to others.

Treatment of keloids can include:

• compression of the earlobe between two buttons after the keloid is removed surgically
• corticosteroids injected directly into the keloid
• cryosurgery, which involves freezing the keloid with liquid nitrogen
• interferon medicines, which interfere with formation of excess skin
• laser surgery to cut out the keloid
• radiation therapy to remove the keloid
• silicone gel dressings
• surgical removal of the keloid

Surgery may be complicated by bleeding, infection, or an allergic reaction to the anesthetic. Not uncommonly, surgical removal of a keloid may cause an even larger keloid to form.

Keloids may continue growing for many years. Keloids do not disappear or become normal in size. Over time, however, they usually flatten and become less pink and obvious.

Any new or worsening symptoms should be reported to the healthcare professional.