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DermatologicalICD-10: L91.0Affects approximately 6-16% of populations with darker skin tones

Keloids

Also known as: Keloid Scars, Hypertrophic Scarring, Raised Scars

Keloids are raised, overgrown scars that develop when the body produces excessive collagen during the wound healing process, extending beyond the boundaries of the original injury. Unlike normal scars that flatten over time, keloids continue to grow and can become much larger than the initial wound, causing cosmetic concerns, itching, pain, and restricted movement depending on their location. Keloids are more common in people with darker skin tones and can form after any type of skin injury, including surgical incisions, piercings, acne, burns, and vaccinations.

Symptoms

Raised, firm, smooth scar tissue that grows beyond the original wound
Pink, red, or darker color compared to surrounding skin
Itching or tenderness at the scar site
Pain or discomfort, especially with pressure or friction
Restricted range of motion if located near a joint
Gradual enlargement of the scar over weeks to months

Causes

  • Abnormal wound healing response with excessive collagen production
  • Genetic predisposition affecting collagen regulation
  • Skin injuries including surgical incisions, piercings, tattoos, and burns
  • Acne scars, especially on the chest, shoulders, and jawline
  • Inflammatory skin conditions that damage the dermis

Risk Factors

  • African, Asian, or Hispanic descent (10-15 times higher incidence)
  • Family history of keloid formation
  • Age between 10 and 30 years
  • Previous keloid formation at any site
  • Wounds on the earlobes, chest, shoulders, or upper arms
  • Wound tension or infection during healing

Diagnosis

  • Visual and physical examination of the scar
  • Dermoscopy for detailed examination of scar characteristics
  • Skin biopsy to differentiate from other conditions such as dermatofibrosarcoma
  • Medical history review including prior keloid formation

Treatment

  • Corticosteroid injections (triamcinolone acetonide) to flatten and soften keloids
  • Silicone gel sheets or silicone-based creams applied daily
  • Surgical excision combined with adjuvant therapy to prevent recurrence
  • Cryotherapy (freezing) to reduce keloid size
  • Laser therapy (pulsed-dye laser) to reduce redness and flatten scars
  • Radiation therapy post-excision for high-risk recurrent keloids
  • Pressure garments for large or post-surgical keloids

Prevention

  • Avoid unnecessary piercings, tattoos, and elective surgeries if prone to keloids
  • Apply silicone gel sheets or cream immediately after wound healing
  • Keep wounds clean, moist, and covered during healing
  • Treat acne promptly to minimize scarring
  • Discuss keloid risk with your surgeon before any planned procedure

When to See a Doctor

  • A scar continues to grow larger beyond the original wound boundaries
  • Keloid causes significant itching, pain, or functional limitation
  • You are prone to keloids and need guidance before a planned surgery or piercing
  • You want to explore treatment options for cosmetically bothersome keloids

Frequently Asked Questions

Related Conditions

Acne Vulgaris

Dermatological

Eczema

Dermatological

Psoriasis

Dermatological

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Medical Disclaimer: This content is for educational and informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider.

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