Keloids are a type of abnormal scar that grows beyond the original boundary of an injury.  Unlike typical scars, keloids continue to grow and can become much larger than the original wound, often causing discomfort and emotional distress.  

What is a Keloid?

A keloid is a raised, reddish-pink scar that grows excessively at the site of a healed skin injury. It can appear anywhere on the body but is most commonly found on the chest, shoulders, earlobes, and cheeks.

Keloids are characterized by the following features:

• They extend beyond the original wound area.

• They are often itchy, painful, and sensitive to touch.

• They can grow slowly over time, sometimes taking months or years to develop fully.

• They commonly appear shiny and smooth, with a reddish or purple color that may fade over time.

• Unlike normal scars, they do not regress on their own.

Causes of Keloid Formation

The exact cause of keloid formation is not fully understood, but several factors are known to contribute to their development.  These include:

1. Genetic Predisposition

Genetics play a significant role in keloid formation. Individuals with a family history of keloids are more likely to develop them. Studies have shown that certain genetic markers are associated with an increased risk of keloid formation.

2. Skin Trauma

Any type of skin injury can potentially lead to keloid formation. Common causes include:

• Acne scars

• Surgical incisions

• Vaccination sites

• Burns

• Ear piercings

• Minor cuts and abrasions

3. Inflammation and Infection

Inflammation and infection at the site of a wound can increase the risk of keloid formation.  Proper wound care and hygiene are essential to minimize this risk.

4. Ethnicity

Keloids are more common in people with darker skin tones, including individuals of African, Asian, and Hispanic descent. This suggests that melanin production may play a role in keloid development.

Symptoms of Keloids

Keloids can cause various symptoms, including:

• Persistent itching and tenderness

• Pain at the site of the keloid

• Restricted movement if the keloid is near a joint

• Emotional distress due to the keloid's appearance

Diagnosis

A doctor typically diagnoses keloids based on their appearance and growth pattern. In some cases, a biopsy may be performed to rule out other skin conditions.

Treatment Options

Treating keloids can be challenging, and no single treatment is universally effective. The choice of treatment depends on the size, location, and severity of the keloid, as well as the patient's medical history and preferences. Common treatment options include:

• Corticosteroid injections are the most common treatment for keloids. These injections help reduce inflammation and flatten the keloid over time. Multiple injections may be required for optimal results.

• Surgical removal of keloids involves cutting out the keloid tissue. However, this method has a high recurrence rate, and the new scar may also develop into a keloid. To reduce the risk of recurrence, surgery is often combined with other treatments, such as corticosteroid injections or radiation therapy.

• Laser therapy can help reduce the size and redness of keloids. It works by targeting the blood vessels within the keloid, reducing blood flow and promoting scar tissue breakdown.

• Silicone gel sheets are applied to the keloid to flatten and soften the scar. They work by hydrating the skin and applying gentle pressure to the keloid.

• Pressure therapy involves applying constant pressure to the keloid using specialized garments or bandages. This method is often used after surgery to prevent keloid recurrence.

• Radiation therapy is sometimes used to treat keloids, particularly after surgical removal. Low-dose radiation can help prevent keloid recurrence by inhibiting the growth of scar tissue.

• Cryotherapy involves freezing the keloid with liquid nitrogen. This treatment can help reduce the size and hardness of the keloid, but it may cause skin pigmentation changes.

Prevention Strategies

Preventing keloid formation is not always possible, but certain strategies can help reduce the risk:

• Avoid unnecessary skin trauma, such as piercings and tattoos, especially if you have a family history of keloids.

• Practice proper wound care, keeping the area clean and protected.

• Use silicone gel sheets or pressure garments after surgery or injury to minimize scar formation.

• Consult a dermatologist at the first sign of abnormal scar growth for early intervention.

Living with Keloids

Living with keloids can be challenging, both physically and emotionally.  The visible nature of keloids can affect a person's self-esteem and quality of life.  Support from healthcare professionals, friends, and family is crucial in managing the impact of keloids.  Seeking emotional support from counselors or support groups can help individuals cope with the psychological effects of keloids. Sharing experiences and learning from others who have similar conditions can be empowering and comforting.

Adopting a gentle skincare routine can help manage keloid symptoms. Avoid harsh products that can irritate the skin and opt for hypoallergenic, non-comedogenic options.

Regular consultations with doctors are essential for monitoring keloids and exploring treatment options. Doctor can provide personalized advice and recommend appropriate interventions based on individual needs.