Keloid Scars

Keloid scars are a type of overgrown scar that develops where the skin has healed after an injury. Unlike regular scars, keloids protrude above the skin surface and extend beyond the original wound site. They are characterised by their thick, raised, and often dark or red appearance. The development of keloids is due to an excessive production of collagen, a protein that plays a key role in wound healing. Keloids can affect anyone but are more prevalent among people with darker skin tones.

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Key Points

What are keloid scars?

Keloid scars are a fibrous skin growths that form over a wound during the healing process. They are distinguished by their raised, thickened nature and can grow to be much larger than the original injury.

Who gets keloid scars?

Keloids can develop in any person who has a skin injury, but they are more common in individuals with darker skin, such as those of African, Middle-Eastern, Asian, or Hispanic descent. People aged between 10 and 30 are more likely to develop keloids. Skin injury can occur from surgical procedures, external trauma, as well as skin conditions such as acne.

Clinical features

Keloid scars typically appear as a raised mass of tissue at the site of a previous injury. They may be dark or red and can continue to grow for weeks or even years. Keloids can be itchy, tender, or painful, especially when they are new.

Diagnosis and differential diagnosis

Diagnosis is often based on the appearance and history of the skin lesion. A biopsy is required in unusual cases to confirm the diagnosis and rule out other types of growths.

Impact and complications

Keloids can impact a person’s appearance and self-esteem, especially if they are in visible areas. They can also cause discomfort or pain, limit mobility, and may recur after removal.

Treatment Options for Keloid Scars

The treatment for keloid scars aims to reduce their size, relieve symptoms, and improve appearance. Injections are often the first-line treatment, using cortisone or anti-metabolite injections to reduce size and itching. Surgery can remove the keloid, but there is a high risk of recurrence. Laser therapy helps flatten keloids and reduce redness, while silicone sheets or gels are applied over the scar to flatten and soften it. Cryotherapy, which freezes the keloid, is effective only in smaller keloids. Radiotherapy is used in select cases, often in combination with surgery. Although treatments can improve symptoms and appearance, the complete elimination of keloids is challenging.

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