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Keloids: Causes, Symptoms and Treatment

Keloids are raised, overgrown scar tissue that extends beyond the original wound boundaries. They can cause itching, pain, or a burning sensation and may develop after any skin injury.

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Things worth knowing about "Keloids"

Keloids are raised, overgrown scar tissue that extends beyond the original wound boundaries. They can cause itching, pain, or a burning sensation and may develop after any skin injury.

What Are Keloids?

Keloids are benign but excessively growing scar formations that extend beyond the boundaries of the original wound. Unlike normal scars or hypertrophic scars, keloids invade the surrounding healthy skin tissue. Although they are not medically dangerous, they can be cosmetically distressing and may cause symptoms such as itching, burning, or tenderness.

Causes

Keloids result from an overproduction of collagen during the wound healing process. The exact cause is not fully understood, but the following factors are known to contribute:

Genetic predisposition and family history
Darker skin types are more frequently affected
Skin injuries such as cuts, burns, acne, or piercings
Surgical scars
Insect bites or vaccination sites

Symptoms

Keloids have a distinct appearance that sets them apart from normal scars:

Raised, smooth, and shiny skin lesion
Reddish to brownish-purple coloration
Growth that extends beyond the original wound margin
Itching, tension, or pain in the affected area
Occasionally, the skin over the keloid may feel warm to the touch

Diagnosis

Keloids are typically diagnosed through a clinical examination by a dermatologist. Based on the appearance, location, and medical history, the diagnosis can usually be made with confidence. In rare cases, a skin biopsy (tissue sample) may be taken to rule out other conditions.

Treatment

Treating keloids can be challenging, as they have a tendency to recur. Several therapeutic approaches are available:

Conservative Treatment

Corticosteroid injections: Direct injection of corticosteroids into the keloid to suppress tissue growth
Silicone sheets or gels: Reducing scar growth through moisture retention
Compression therapy: Applying sustained pressure to the scar tissue

Medical Procedures

Cryotherapy: Freezing the tissue to reduce the size of the keloid
Laser treatment: Reducing blood flow and tissue volume
Surgical removal: Recommended only in combination with other measures due to a high recurrence risk
Radiation therapy: Post-surgical irradiation to prevent recurrence

Prevention

Individuals with a known tendency to develop keloids should avoid unnecessary skin procedures. After injuries or surgeries, early use of silicone sheets and compression garments can help reduce the risk of keloid formation.

References

Berman, B. et al. (2020): Keloids and Hypertrophic Scars. In: American Journal of Clinical Dermatology, 21(3), 301-315.
Ogawa, R. (2017): Keloid and Hypertrophic Scars Are the Result of Chronic Inflammation in the Reticular Dermis. International Journal of Molecular Sciences, 18(3), 606.
World Health Organization (WHO): Wound Healing and Scar Management. Geneva: WHO Press.

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