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Keloids

Hypertrophic scar; Keloid scar; Scar - hypertrophic

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Juckett G, Hartman-Adams H. Management of keloids and hypertrophic scars. Am Fam Physician. 2009;80(3):253-260

Romanelli R, Dini V, Miteva M, et al. Dermal Hypertrophies. In: Bolognia JL, Jorizzo JL, Schaffer JV, et al, eds.Dermatology. 3rd ed. Philadelphia, Pa: Mosby Elsevier; 2012:chap 98.



 

Definition

A keloids is a growth of extra scar tissue where the skin has healed after an injury. 

Causes, incidence, and risk factors

Keloids can form after skin injuries from:

  • Acne
  • Burns
  • Chickenpox
  • Ear piercing
  • Minor scratches
  • Cuts from surgery or trauma
  • Vaccination sites

The problem is more common in people ages 10 to 20, and in African Americans, Asians, and Hispanics. Keloids often run in families.

Symptoms

A keloid may be:

  • Flesh-colored, red, or pink
  • Located over the site of a wound or injury
  • Lumpy (nodular) or ridged
  • Tender and itchy
  • Irritated from friction such as rubbing on clothing

A keloid will tan darker than the skin around it if exposed to sun during the first year after it forms. The darker color may not go away.

Signs and tests

Your doctor will look at your skin to see if you have a keloid. A skin biopsy may be done to rule out other types of skin growths (tumors).

Treatment

Keloids often do not need treatment. If the keloid bothers you, the following things can be done to reduce the size:

  • Corticosteroid injections
  • Freezing (cryotherapy)
  • Laser treatments
  • Radiation
  • Surgical removal
  • Silicone gel or patches

Many of these treatments can cause a larger keloid scar to form.

Expectations (prognosis)

Keloids usually are not harmful to your health but they may affect how you look. In some cases, they may become smaller, flatter, and less noticeable over time.

 

Calling your health care provider

Call your health care provider if:

  • You develop keloids and want to have them removed or reduced
  • You develop new symptoms
Prevention

When in the sun, cover a keloid that is forming with a patch or Band-Aid, and by use a sunblock. Continue follow these steps for at least 6 months after injury or surgery for an adult, or up to 18 months for a child.

Imiquimod cream can be used to prevent keloids from forming after surgery, or returning after they are removed.