Keloid Scars: Common Causes & How to Reduce Their Appearance

Aesthetics Hub | 3 Nov 2016

Keloid scars are made up of scar tissue that, for some unknown reason, grows excessively on the site of a wound. They are raised, hard, lumpy and often bigger than the skin damage which caused the scar in the first place. 

Ten to 15% of all wounds result in keloid scars. Because of the way they look they are often more of a cosmetic problem than a health concern but that doesn't mean nothing can be done about them.

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Credit: Blogspot My Keloid Treatment
 

Who gets them?

It's not known for sure why some people get keloid scars, but you are more likely to get them if you're aged between 10 and 30 years old, have dark skin (such as people from African, African-Caribbean and south Indian communities), and you, or someone in your family, has had them before. Five to 10% of Europeans with keloids have a family history of them.


Keloid scars are a pink or purple colour and can happen anywhere but most commonly form on the upper chest, shoulders, head (especially the earlobes) and neck.

 

Causes

Keloid scars can develop after even minor skin damage, such as from insect bites and chicken pox, but they can sometimes happen spontaneously with no history of skin trauma. Sometimes they don't form until months or even years after the initial injury.

Wounds that get infected, or that are under tension while healing, are more likely to form keloids, as are burn and acne scars.
 

Symptoms

Keloid scars can be tender to touch, itchy, or cause a burning sensation. You may find them irritated by clothes rubbing against them. If they're near a joint and are tight they can limit movement.

However, perhaps the biggest problem is their appearance, which can cause embarrassment and anxiety.

 

Diagnosis

In most cases a doctor will make the diagnosis of a keloid just by looking at it. No investigations are usually needed.

They are not contagious and there is a very small risk of them turning into skin cancers, but this is more likely if they are treated with radiotherapy.

 

Treatment

Treatment can be difficult and isn't always successful.

Scars can never be completely removed but can be made less visible.

To help flatten a keloid you can have:

- Steroid injections directly into the scar – this may help to flatten small early ones
- Apply steroid-impregnated tape for 12 to 24 hours a day
- Apply silicone gel sheeting on healing skin (not open wounds) for 12 hours a day, for at least 3 months. Silicone gels or sheets are available from some pharmacies.
- Use pressure bandages to provide long-term compression.

Other options include:

- Freezing early keloids with liquid nitrogen to stop them growing
- Laser treatment to reduce redness – but this won't make the scar smaller
- Surgery to remove the keloid, sometimes followed by radiotherapy for the most severe cases. It is effective about 70% of the time
- Surgery followed immediately afterwards with steroid injections at the site of the removed scar
- Interferon injections - recent studies of interferon injections have shown promise in reducing the size of keloids, although it's not certain how long the effects will last
- Fluorouracil injections - this chemotherapy agent, injected alone or together with steroids, has been used as a treatment for keloids
- Dermal fillers can be used to 'plump' any scars that are pitted. However, results are usually temporary
- Skin needling - rolling a small device covered in hundreds of tiny needles across the skin is reported to be helpful but results vary and repeat treatments are often needed.

Not all the above treatments are widely available on the NHS so you may need to pay privately for them. More research is needed to assess the effectiveness of the different treatments.

 

Tips

Don't try and remove a keloid scar yourself. Picking, puncturing or trying to pop a keloid scar won't remove it and could make things worse. Removing a keloid may result in a bigger one appearing later in the same place.

Massaging a moisturiser cream into a keloid scar will keep it from becoming dry and itchy.

 

How to avoid them

You can reduce your risk of getting keloid scars by avoiding any deliberate cuts or breaks in the skin, such as tattoos or piercings.

Keloids exposed to the sun can become darker and so stand out more. It's best to keep the scar protected from the sun with clothes or sunscreen.

If you're bothered by a keloid scar seek medical advice.
 
 
This article first appeared in Boots WebMD.
 
Our Panel of Doctor's Services
Dr. Dylan Chau, Celevenus Aesthetic & Wellness Clinic
Scar Treatment, $1,200
To achieve facial volume replacement, Sculptra, through natural collagen stimulation with l-poly-lactic acid, and Fractionated or "pixilated" carbon dioxide CO2 lasers are the recommended procedures.
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Dr. Terence Tan, Halley Medical Aesthetics
Acne Scars Programme
Get rid of the ugly acne scars and pigments left behind with a treatment focused on skin renewal and skin smoothening. This programme includes two fractional CO2 laser treatments and two glycolic acid peels.
277 Orchard Road, #03-15 Orchard Gateway, Singapore 238858