Keloid Scar

What is a keloid scar?

A keloid scar (keloid) is a raised scar that grows larger than the wound that caused it. These scars tend to grow slowly — they can take months to years to develop after a skin injury. 

These scars don’t fade. They may affect your self-esteem and how you feel about the way you look. A healthcare provider can offer treatments to reduce the appearance of the scar on your skin.

Where do keloid scars grow?

You can get a keloid scar anywhere on your skin. The most common places may include your:

• Abdomen.
• Back.
• Chest.
• Ear.
• Jaw.
• Shoulder.

What are the symptoms of a keloid scar?

The symptoms of a keloid scar include:

• A raised scar that’s bigger than the wound that caused it.
• Itchy skin.
• Pain and tenderness, a burning sensation or discomfort while the scar grows.

In some cases, the scar may grow big enough to change the function or decrease the range of motion of that area of your body.

What does a keloid look like?

Keloid scars look different on each person. They vary in size, shape, texture and color and can be:

• Round, oval or oblong (rectangular-oval) shape.
• Raised or elevated from the skin around it.
• Discolored (pink, red, purple, brown, darker than your natural skin tone or dark around the edges with a light center).
• Any size.
• Hard or soft.
• Smooth and shiny or wrinkled.

Do keloid scars hurt?

You may experience some pain if you have a growing keloid scar. It might feel tender or like a burning sensation just under your skin near the scar. These can be especially uncomfortable if you have a scar on a joint. This may cause irritation when you move.

Discomfort might go away when the scar stops growing but you may still experience pain with pressure on the keloid.

What causes keloid scars?

A keloid scar happens when your body produces more collagen than it needs to heal an injury. Collagen is a protein that gives your skin support and strength. After an injury, collagen helps bring structure to the wound and aids in rebuilding your skin. Too much collagen after damage to your skin causes a keloid. Providers don’t know exactly why this happens. 

How do you get keloids?

Keloids could develop after changes to your skin or an injury like:

• Acne.
• A bug bite.
• Chickenpox.
• A cut or burn.
• A piercing or tattoo.
• Shaving.
• A surgical incision like a cesarean section (C-section).

What are the risk factors for a keloid scar?

You may be more at risk of developing a keloid scar if you:

• Have a biological relative who gets these scars.
• Have a dark skin tone.
• Are of African, Asian or Hispanic descent.
• Are between 10 and 30 years old.
• Are pregnant or going through puberty (or other hormonal changes). 
• Have an underlying genetic condition like Rubinstein-Taybi syndrome.

You may have a genetic trait that makes your body more likely to make more collagen. This is known as keloid-prone skin. The exact gene that causes this is unknown.

What are the complications of a keloid scar?

Complications of a keloid scar may include:

• Permanent skin darkening on the scar with sunlight exposure.
• Pain that continues when the scar stops growing.
• Low self-esteem and/or social isolation due to appearance changes.

How is a keloid scar diagnosed?

A healthcare provider will diagnose a keloid scar after a physical examination. Testing usually isn’t needed since the appearance of the scar leads to an accurate diagnosis. If your provider suspects another condition or wants to rule out another possible condition, they may perform a skin biopsy to examine a small piece of your affected skin tissue under a microscope. 

How is a keloid scar treated?

A common keloid treatment to soften the lesion and then treat the blood vessels to help prevent future growth may include alternating between the following:

• Medications (corticosteroid injections or creams or 5-fluorouracil injections).
• Laser skin resurfacing (focused beams of light directed at the scar).

Other treatments may include:

• Cryotherapy (freezing the scar).
• Pressure garments (tight clothing to put pressure on an area of your body).
• Ligature (tying a surgical thread around the keloid to encourage it to naturally fall off).

A provider will determine what type of treatment is best based on the scar’s size, shape and how deep it is in your skin. Your general health and age can be factors, too. It usually takes more than one form of treatment to address keloids.

Don’t attempt any form of treatment without approval or guidance from a healthcare provider.

Keloid removal surgery

Keloid scar removal surgery is possible, but it comes with side effects. Your provider usually won’t recommend surgery on its own. Injuring the skin with a surgical incision can make the scar worse and grow back bigger. Your provider may offer corticosteroid injections before surgery to prepare your skin for the procedure, followed by wearing compression garments to reduce the likelihood that the keloid will return.

Radiation therapy for keloids

A less common form of treatment is radiation therapy. This is usually a form of treatment after removal surgery to make sure the keloid doesn’t return. The side effects may outweigh the benefits, so your healthcare provider will review your situation to make sure it’s safe.

Are there side effects of the treatment?

Your healthcare provider will discuss the side effects of treatment with you before you begin. They’ll also let you know how you can take care of your skin to increase the success of treatment.

Keloids may reduce or shrink after corticosteroid injections. Unfortunately, treated keloids might return after treatment. You may notice skin discoloration (light spots) at the site of corticosteroid injections.

If your provider recommends pressure garments, you’ll likely need to wear those for up to 20 hours per day, possibly for weeks or months. Many people report that these garments aren’t the most comfortable to wear, so wearing them for the required amount of time can be a challenge. Talk to your provider if you have trouble wearing the pressure garments they recommend.

How can I prevent keloid scars?

You can’t prevent keloid scars. If you know you’re at a higher risk of getting one, you can take steps to reduce your risk by:

• Protecting your skin from injury and wearing safety equipment when necessary.
• Not getting piercings or tattoos.
• Using a silicone gel patch or wound dressing on your skin after an injury.
• Wearing bug spray when outdoors.

Your provider can give you more information about prevention methods based on your situation.

What can I expect if I have a keloid scar?

Keloids can change your appearance. You might feel self-conscious and avoid social activities because of the scar on your skin. Talking to a mental health professional can help rebuild your self-confidence if the scar affects the way you think and feel about your body.

Treatment can reduce the keloid’s size and shape. Not every form of treatment gets rid of keloids completely, but it can significantly change the way the keloid looks. Keep in mind that if you injure your skin, you’re at risk of getting another keloid scar or having a scar return after treatment.

Do keloid scars go away?

Keloid scars don’t go away on their own. With the help of a healthcare provider like a dermatologist, you can reduce the size and appearance of a keloid scar with treatment.

When should I see a healthcare provider?

Visit a healthcare provider if you have a keloid scar that:

• Affects your appearance and/or self-esteem.
• Causes pain.
• Affects how you move.
• Isn’t getting better with treatment.
• Comes back after treatment.

Which questions should I ask my healthcare provider?

• What type of treatment do you recommend?
• Are there side effects of treatment?
• What caused the scar?
• How do I prevent future injuries that lead to scars?
• Is it safe for me to get piercings or tattoos?