What are Keloids?
Keloids are raised, red or deep purple scars that can occur at the site of an injury, such as a scrape, burn or cut. Unlike a typical scar, keloids are larger than the original injury. They are smooth and hard to the touch. Although they can occur anywhere on the body, keloids are most commonly found on the cheeks, earlobes, shoulders or chest. The size of a keloid can vary greatly, from that of a sunflower seed to a softball.
Keloids do not appear right away. They typically emerge about three months after the injury and can take more than a year to fully develop. Keloids can continue to grow for years after they first appear, causing physical and emotional distress. They will stop growing eventually; however, they will not disappear without intervention from a skilled Atlanta dermatologist.
Many patients seek treatment strictly because of cosmetic concerns, especially if the keloid is on a visible part of the body such as the cheeks or ears. Some keloids may cause itchiness, pain or discomfort. If a keloid forms over a joint, it can decrease the range of motion.
Why Do Keloids Form?
Keloids can develop as a result of trauma to the skin. Rarely, people will develop a keloid without previous injury to the body. These keloids are referred to as “spontaneous” keloids. When a keloid-prone person sustains an injury to the skin, their body goes into overdrive in an attempt to heal the injury. It will begin to overproduce collagen, the building block of scar tissue, long after the initial wound is closed.
Most commonly, a keloid will form at the site of trauma to the skin. Some injuries where keloids tend to occur include:
- Scrapes Cuts
- Burns
- Body piercing, especially the ears
- Tattoos
- Chickenpox
- Surgery
- Acne
- Vaccination sites
Who Is at Risk for Developing Keloids?
While anyone can develop a keloid, some people are more prone to them than others. Genetics appears to be a factor in the development of keloids. There are certain groups who are more likely to develop keloids, including Asians, African Americans, and Hispanic Americans. Keloids frequently occur in young people between the ages of 10 and 30. Pregnant women tend to have a higher risk of developing keloids.
For those who have a genetic predisposition to keloids, there are some precautions you can take to prevent one from forming on your skin. Avoid body piercings, tattoos, and any unnecessary surgeries. When an injury to the skin does occur, take care of the wound right away and see your dermatologist. If surgery is required, be sure to inform your doctor. There are measures that a surgeon can take to reduce the risk of developing a keloid.
Keloid Treatment Options
Keloids are not dangerous or cancerous; however, many people obtain keloid treatment when the keloids are itchy, tender or uncomfortable. Others choose to treat keloids for cosmetic reasons or to improve mobility if the keloid develops on a joint.
There is no one-size-fits-all treatment for keloids. In fact, it is common for a treated keloid to return over time. Your dermatologist may suggest a combination of treatment options to obtain your optimal results. However, it is important to understand that treatment may not completely remove the keloid or give you the results that you desire. A dermatologist may recommend available treatments including:
- Silicone Pads: Moist sheets of silicone gel are placed over the keloid to reduce the size of the scar. This is a safe and more conservative treatment option.
- Pressure Dressings: Constant compression is applied to the keloid to reduce it in size. This treatment may require compression for six months to one year.
- Topical Treatments: Applied directly to the keloid, medications can include retinoids, steroids and anti-inflammatory ointments.
- Cryosurgery: Using liquid nitrogen to freeze the keloid, treatment must be repeated monthly and can result in lightening of the skin.
- Injections: Corticosteroid injections, repeated every four to six weeks, can soften and reduce the size of a keloid.
- Laser Treatments: Most commonly used in combination with other treatments, laser treatments can flatten and lighten the appearance of the keloid.
- Surgical Procedures: The physical removal of a keloid, surgery is often paired with other treatment options to reduce the risk of the keloid returning. Most keloids do reappear after surgical treatment.
Although a keloid may not pose any serious health risks, it is still important to contact a dermatologist to learn more about proper care, prevention and keloid treatment. There are a range of treatment options available, from conservative dressings and compression to more advanced laser treatments and surgery. Your dermatologist will make sure you fully understand your options and provide recommendations that are appropriate for your skin.
Frequently Asked Questions About Keloid Treatment
Can keloids be permanently removed?
Keloids can often be reduced in size and appearance, but permanent removal is not always possible. Even after successful treatment, keloids may return because the skin continues to produce excess scar tissue. Treatments such as corticosteroid injections, cryotherapy and surgical removal may help flatten or soften keloids. Combining treatments can sometimes reduce the likelihood of recurrence. Dr. Straughn evaluates each patient's keloids to recommend an appropriate treatment approach.
What is the best keloid treatment for darker skin tones?
The most appropriate keloid treatment depends on the size, location and characteristics of the scar, as well as the patient's skin tone. People with darker skin may be more susceptible to pigmentation changes following certain procedures, including cryotherapy and laser treatments. At Buckhead Dermatology, Dr. Straughn has extensive experience treating skin of color and considers the risks of hyperpigmentation, hypopigmentation and additional scarring when developing individualized treatment recommendations.
How many steroid injections are needed to flatten a keloid?
The number of corticosteroid injections needed depends on the size, thickness and response of the keloid. Treatments are commonly administered every four to six weeks, and several sessions may be necessary to achieve noticeable improvement. Steroid injections can help soften and flatten raised scar tissue while reducing itching or discomfort. Some keloids respond better than others, and additional treatments may be recommended depending on the results.
Can keloids develop after acne or ear piercings?
Yes. Keloids can develop following acne, ear piercings or other injuries that damage the skin. They form when the body produces excessive collagen during healing, creating raised scar tissue that extends beyond the original injury. People with a personal or family history of keloids may be more likely to develop additional growths. If you are prone to keloids, avoiding unnecessary piercings and seeking early treatment for inflammatory acne may help reduce your risk.
When should I see a dermatologist for a growing or painful keloid?
You should consider seeing a dermatologist if a keloid continues to grow, becomes painful or itchy, or interferes with movement or daily activities. Early evaluation may help identify treatment options before the scar becomes larger or more difficult to manage. Any rapidly changing or unusual growth should also be examined to confirm the diagnosis. Conveniently located in Buckhead, Atlanta, Buckhead Dermatology provides individualized keloid evaluations and treatment recommendations for patients throughout Atlanta, Sandy Springs and Brookhaven.