Keloid 

Keloids are scars on your skin that have healed after an injury. It is a thick raised scar that usually appears on earlobes, shoulders, cheeks, or chest. Scars that form as a response to any burn, wound, abrasion, or cut are a part of your body's natural healing process. These usually grow smaller and fade over time; however, the skin may overreact for some, forming larger scars such as keloids. Although keloids do not cause pain or discomfort, they are often a cause of concern for aesthetic reasons. Treatment options may include home remedies, medications, injectables, laser therapy, or surgical intervention. 

This article offers a comprehensive guide to keloids, including their causes, symptoms, diagnosis, treatment, and prevention. 

What is a Keloid?

A keloid is a smooth, glossy, raised formation of an overgrown scar tissue or an overly aggressive healing response to a wound or injury. These scars can form on your earlobes, neck, chest, shoulders, and back. Keloids are pink, purple, or brown and may feel rubbery or firm. These scars are usually darker than the surrounding skin and may gradually enlarge than the wound that caused them. 

What Causes Keloid?

The exact cause of keloid is not known. Many experts believe it is likely a dysfunction of the wound-healing process. Collagen is an essential protein in your body that forms the binding and building blocks of tissues like skin, hair, nails, muscles, tendons, ligaments, and cartilage. It is an essential component during the wound healing process. However, keloid scars are formed when your body produces too much collagen. 

Keloids are noncancerous and noncontagious growths that can be triggered by any kind of injury, including:

• Cuts
• Animal bites
• Acne 
• Burns
• Piercing 
• Puncture wounds 
• Hair removal 
• Minor scratches and bumps 
• Tattoos
• Surgical scars 

Risk Factors

Several risk factors can also predispose you to the formation of a keloid scar. These include:

• Having brown or black skin 
• Having a family history of keloids 
• Aged below 30
• Being pregnant 
• Being a teenager going through puberty 
• Hormonal changes such as those seen in thyroid conditions may increase your odds of developing keloid scars

What Are the Symptoms Associated with Keloid?

An overreacting scar tissue forms a keloid that may take weeks or months to develop fully. Keloids can present with the following characteristics:

Slow Growth

• It can take months to a year for the keloids to appear. They may gradually continue to grow slowly for years. 

Appearance

• The keloid scars begin as red, pink, or purple raised scars with flat tissue. 
• The color may darken, and the scar appears darker than the surrounding skin.
• Keloids can range from smaller than an inch to 12 inches or more. 
• Keloids can be aesthetically unappealing, which may make you feel self-conscious. 

Consistency

• Keloid scars feel soft and doughy in consistency, while some can be firm and rubbery.

Tender and Painful

• While growing and enlarging, some keloids can be extremely itchy, tender, or painful to touch.
• If the keloids are large and hardened, they may restrict your movement.

Psychological Effects

• The unaesthetic appearance of keloids can cause psychological symptoms like stress, anxiety, depression, and social embarrassment.

How is a Keloid Diagnosed?

Keloids can be easily diagnosed by an experienced dermatologist (a doctor specializing in diagnosing and treating conditions related to the skin, hair, and nails) who will evaluate your symptoms and record your medical and family history. The doctor will physically examine the keloid scar to assess its shape, size, appearance, and growth pattern. 

Furthermore, your doctor may order a skin biopsy (a tissue sample is taken and studied under a microscope) test to rule out other skin growths or malignancies (the ability to become cancerous). 

How Are Keloids Treated?

Treating keloid scars can be challenging, and these may grow back even after surgical removal, or you may notice new ones developing. Your dermatologist can suggest one or more combinations of treatments to treat keloids. These include:

Conservative Methods 

Wound Care

• Compression dressings used to pressure the wound can greatly prevent the formation of keloid scars or reduce their size.
• These dressings must be worn 12 to 24 hours daily for 3 to 4 months. 

Home Remedies

• Garlic: Stops the enzymes that build up scar tissue and pigment from entering a keloid.
• Honey: Reduces the size of the keloid by minimizing inflammation. 
• Onion: Inhibits the cells called fibroblasts to enter the skin. These cells are responsible for the scar tissue. 

Medical Therapy

Whenever conservative methods fail to work, your dermatologist may recommend medical treatment. These have been discussed below:

Topical Creams

• These topical creams often consist of steroids directly applied to the keloid scar or as patches. 

Silicone Gels and Patches 

• Silicone gels or patches reduce inflammation, thereby minimizing the size and color of the scars. 

Injectables

• Steroid intralesional injectables are beneficial to reduce scar size. It is the most common medical treatment where the doctor injects the steroids directly into the keloid. 
• Recent advances also favor the use of Botox injections for treating keloids since it is an effective neurotoxin. 

Cryotherapy

• This is a popular freezing therapy that typically works for more minor scars.
• Here, liquid nitrogen is used to reduce the size of the keloid scar.

Laser Therapy

• This procedure involves using pulsed-dye laser light to target the keloid tissues, thereby fading the scar. 
• You may require several sessions with an interval of 4 to 8 weeks between sessions. 

Radiotherapy

• Low-level X-ray radiation may be used alone or post-surgical removal of the keloid tissue.
• Radiotherapy can help shrink the scar tissue and its size. 

Surgery 

• Surgical intervention is often the last resort when other methods fail. 
• Here, the entire keloid tissue is removed using a surgical blade, and the wound is sutured. 

Can Keloids Be Prevented?

Keloids have a high recurrence rate, irrespective of the treatment option used to remove them. However, you may follow some tips to reduce your likelihood or risk of developing a keloid scar. 

• Wash the wound area immediately with soap and water 
• Use sterile petroleum gauze to bandage the area
• Clean the wound daily until it heals
• Protect the wound from excess sun exposure 
• Try to avoid body piercing, tattoos, or elective surgery 

Summary 

A keloid is a smooth, shiny, raised scar usually larger than the actual wound or injury. It appears darker than the surrounding skin. Though it may not be cancerous, it is challenging to treat a keloid due to its high recurrence rate. Treatment can be possible through wound care, home remedies, or medical methods like topical creams, patches, injectables, cryotherapy, laser therapy, radiation, or surgical intervention. 

Consult your dermatologist if you notice any scar. They can help determine the best course of action for you.