KELOIDS

 Basic information

description

Keloids are an overgrowth of fibrous tissue (scar) on the skin. They can appear anywhere on the skin, but most commonly appear on the earlobes, chest, upper back, and shoulders. Keloids are more frequent in black people than in white people and occur more often in young women.

FREQUENT SIGNS & SYMPTOMS

• Keloids begin as a small bump. The lump grows and turns into firm, raised, hard scars that are slightly pink.
• Scars may continue to grow over a period of time.
• Keloids may have itchiness, burning sensation, pain, or tingling.
• They may become a cosmetic problem.
• May become irritated from rubbing on clothing.

causes

Keloids probably occur due to a defective healing process. An excess of collagen forms at the site of a healing scar. Keloids usually arise in an area of injury (such as after a burn or from severe acne), but sometimes arise from a very minor scratch. Why they occur in certain people is unknown.

risk increases with

• Certain persons:
  • Family history of keloids.
  • Personal history of keloids.
  • Darkly pigmented skin (Blacks, Hispanics, Asians).
  • During pregnancy or puberty.
• Other risk factors:
  • Surgical wound or burn injury (especially if healing is delayed more than 3 weeks).
  • Acne.
  • Body piercing.
  • Vaccination or biopsy.
  • Insect bite.
  • Folliculitis barbae (inflammation of a hair follicle).

PREVENTIVE MEASURES

For patients with known tendency to keloid formation, avoid risk factors where possible. Avoid elective surgery. If a surgical procedure is necessary, special precautions should be taken.

expected outcomes

Keloids are difficult to treat. The response to different treatments varies among patients. Treatment may soften, flatten, lighten color, decrease size, or improve texture of the keloids. Keloids are generally considered harmless and noncancerous.

possible complications

• They may recur, despite treatment.
• Emotional distress.

 diagnosis & treatment

general measures

• Your health care provider can diagnose keloids by their appearance on the skin. Other medical tests are usually not needed, but may be done to rule out any other skin problem.
• No single treatment is best for all keloids. There are a variety of treatment options and the options can be combined. Your health care provider will discuss them with you.
• Treatment may include injections into the scars.
• Occlusive dressings include silicone gel sheets and dressings, nonsilicone sheets, and a clear surgical tape.
• Compression therapy includes different products that are used to apply pressure to the keloids.
• Laser therapy or radiotherapy (radiation) are options.
• Cryotherapy involves freezing the affected area with liquid nitrogen.
• Surgery (excision) may be done if other treatments are not successful. Surgery is usually combined with pressure therapy, injections, or radiotherapy.
• Other therapies (e.g., light therapy) are being studied.

medications

• Injection of corticosteroid drugs directly into the keloid. May be repeated every 3 to 4 weeks until desired degree of flattening and softening has been achieved.
• Other types of injections or topical drugs may be prescribed.

activity

No limits.

diet

No special diet.

 notify our office if

• You or a family member has signs of keloids.
• Keloids recur after treatment.

Special Notes: