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Keloid(Keloid Scar; Dermal Fibrotic Lesion)

Pronounced: KEE-loyd

Definition

A keloid is an extra growth of scar tissue over a skin wound. It grows beyond the margins of the skin wound. A keloid can vary in size from one to several inches. They are not harmful to general health.

Keloids can occur anywhere but they are more common on:

  • Earlobes
  • Shoulders
  • Upper back
  • Chest
  • Back of scalp and neck
Causes

Scar tissue is a part of the normal healing process. With keloids, the scar tissue grows in an uncontrolled manner. The scar continues to grow even after the wound has been covered. The growth can continue for weeks or months.

Risk Factors

Keloids are more common in people with African American, Asian, or Hispanic ethnicity. They are also more likely to occur between 10-30 years old.

Factors that increase your chance of keloids include:

  • Deep skin wounds, such as those from infections, burns or surgical scars
  • Scars from acne, vaccinations, or chickenpox
  • Family history

Normal Surgical Scar

Post-operative scar

Ideally the scar tissue would stop developing at this point.

Copyright © Nucleus Medical Media, Inc.

Symptoms

Keloids often begin as small lumps at the site of a skin injury. They gradually grow beyond the edges of the wound.

For most, the scar is the only symptom. Some may have other symptoms such as:

  • Pain
  • Burning
  • Itchiness
  • Tenderness
Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done.

You may be referred to a skin specialist. They can confirm the diagnosis and assist in removal. A plastic surgeon may do the removal.

Your doctor may order a biopsy. This test will rule out other problems like a tumor or other skin disorders.

Treatment

Some keloids may go away on their own, but this is rare. If the keloid is not bothersome, then it does not need to be treated.

A large or irritating keloid may be removed with surgery. Most keloids will grow again after surgery. Other treatments may help to prevent recurrence. Prevention treatment options include:

Corticosteroid Injections

These injections are often given with surgery. They are repeated every 3-4 weeks for six months. Steroids can relieve itching and pain and slow the scar formation. For some, it may cause some shrinking of the keloid.

Radiation Therapy

Your doctor may recommend radiation after surgery. This therapy can be successful at stopping regrowth. However, it is a limited option because it is toxic to healthy tissue.

Other Medications

Other medications that may also help prevent regrowth of a keloid after surgery include:

  • Verapamil—injected directly into area
  • Fluorouracil—injected directly into area
  • Imiquimod—cream applied to the affected area
Prevention

To help reduce your chances of forming a keloid, take the following steps:

  • Avoid trauma to the skin.
  • Care for cuts or scrapes right away.
  • Avoid unnecessary cosmetic surgery.
  • Do not tattoo or pierce your ears or other areas of the body.

RESOURCES:

American Academy of Dermatology
http://www.aad.org

American Society of Plastic Surgeons
http://www.plasticsurgery.org

CANADIAN RESOURCES

Canadian Dermatology Association
http://www.dermatology.ca

Health Canada
www.hc-sc.gc.ca

References:

Scar revision. American Society of Plastic Surgeons website. Available at: http://www.plasticsurgery.org/Reconstructive-Procedures/Scar-Revision.html. Accessed August 5, 2013.

Conejo-Mir JS, Corbi R, et al. Carbon dioxide laser ablation associated with interferon alfa-2b injections reduces the recurrence of keloids. J Am Acad Dermatol.1998; 39:1039.

Keloid. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us. Updated July 18, 2013. Accessed August 5, 2013.

Malaker K, Vijayraghavan K, et al. Retrospective analysis of treatment of unresectable keloids with primary radiation over 25 years. Clin Oncol. 2004;16:290.

Shaffer JJ, Taylor SC, et al. Keloidal scars: A review with a critical look at therapeutic options. J Am Acad Dermatol. 2002; 46:S63.



Last reviewed August 2013 by Michael Woods, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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