Keloids

This is the name given to excessive scar tissue which has formed at the site a wound or injury. Scarring is a sign that the body is healing following an accident or injury but in some cases, the scars keep on growing which leads to lumpy, thick scar tissue. These scars may itch as they develop.

There are situations where the scar tissue is bigger than the actual injury. This often results in bulky, unsightly looking scars which can be distressing for the sufferer especially if they develop on the face.

Keloids occur in younger rather than older people and mostly affect dark skinned races. They can develop on regular occasions.

What is a scar?

A scar is a mark which forms as a result of an injury, for example a burn, and is a visible sign of the healing process. Normal scars have a pale appearance although larger scars take on a dark colour if extra scar tissue is needed. But this fades over time.

How does a scar form?

If your skin is cut, grazed or damaged in any way then this triggers extra production of collagen – a protein found in the connective tissues which is strong, flexible and acts as a support to the rest of the body. Extra collagen repairs any damage to the skin and closes the area. The result is a thin line or scar.

This process is repeated over a period of months which leads to a smaller and smoother looking scar.

But things can go wrong. If they do then abnormal scars develop which include hypertrophic scars (angry red, raised scars) and keloid scars (lumpy pink or red scars).

Causes of keloids

There are several causes of keloids which include:

  • Surgical incisions
  • Burns
  • Cuts
  • Acne
  • Ear piercing
  • Injection sites

Infectious skin conditions such as chickenpox can result in keloid scars. Plus keloid scars often run in families.

Keloids often form on parts of the body which are prone to abnormal scars. These include the top of the shoulder, centre of the chest, top of the back and the earlobes. Plus certain skin types tend to develop keloids more than others.

Symptoms of keloids

A keloid scar is thick, misshapen, smooth and shiny. It is itchy or causes a burning sensation and is painful to the touch. If it has developed near to or over a joint then it will limit the movement in that area.

It has a hard, rubbery feel and has a dark red or purple colour which fades as the scar ages.

Diagnosing keloids

Your GP will be able to diagnose a keloid scar (or scars) by examining the affected area on your body. You may be referred to a dermatologist for a skin biopsy to determine the precise cause.

Treatment for keloids

Many people find keloids embarrassing and unattractive. They cannot be entirely removed but their visibility can be reduced so that they are less noticeable and less distressing.

Treatment options include:

These are all good ways of dealing with abnormal scars.

Corticosteroids are injections into the skin which reduce any swelling and the size and shape of the scar. These may be repeated if necessary.

Laser therapy involves aiming a beam of light at the scar tissue which triggers the release of healthy scar tissue instead. This tissue replaces the abnormal scar tissue in an ongoing process until the scar becomes flatter and smaller.

Cryosurgery is based on using extremely cold temperatures to treat damaged skin or abnormal scar tissue. Liquid nitrogen is sprayed onto the affected area which freezes and kills the keloid scar.

Surgery is another option in which the scar is reduced in size, moved into a more favourable position or altered in shape. Some keloids are very tight but surgery can be performed to release this pressure.

Silicon gel sheets are thin sheets which are placed over the scar and left in position for 14 hours each day for up to 2 months. The keloid and sheet must be washed with soap and water on a daily basis. These sheets help to reduce the size and shape of the scar.

Medication can be prescribed which will break down any abnormal scar tissue.

Camouflage creams and lotions are useful for disguising a keloid scar or other forms of skin damage.

Prevention of keloid scars

If there is a history of keloids in your family then you are at increased risk of developing these. Plus if you have had a keloid scar before then it is highly likely you will get it again.

You are powerless to prevent a keloid scar from occurring but there are ways in which you can reduce the risk. This includes ensuring that any cut, however small, is properly cared for and avoid tattoos and facial/body piercing.