Keloid Scars: Causes, Treatment Options, and Prevention Tips
A keloid scar is a raised type of scar that develops when the body produces too much scar tissue while healing an injury. Unlike an ordinary scar, a keloid can continue growing beyond the original boundaries of the wound. It may appear after a cut, burn, surgery, acne, vaccination, or body piercing.
Keloids are usually harmless and are not contagious. However, they can sometimes cause itching, tenderness, pain, or discomfort. They may also become a cosmetic concern, especially when they develop on visible areas such as the ears, neck, chest, shoulders, or face.
Although there is no single treatment that works for every keloid, several medical treatments can make the scar flatter, softer, less noticeable, and less uncomfortable. Because keloids can return after treatment, a dermatologist may recommend combining more than one treatment.
What Is a Keloid Scar?
A keloid is a type of raised scar that grows larger than the original wound. It develops because the skin produces excessive scar tissue during the healing process.
Keloids can take weeks or even months to become noticeable after an injury. Once they begin developing, they may continue to grow slowly for months or years. Unlike many ordinary scars, keloids generally do not disappear on their own.
The appearance of a keloid can vary from person to person. It may be pink, red, darker than the surrounding skin, or flesh-colored. The scar may feel firm or rubbery and can sometimes become itchy or painful.
For more information, see the American Academy of Dermatology's information about keloids.
What Causes Keloid Scars?
Keloids can develop after almost any type of skin injury. Common triggers include:
- Cuts and other wounds
- Surgical incisions
- Burns
- Acne
- Body piercings
- Vaccinations
- Insect bites
- Other forms of skin trauma
Not everyone who experiences these injuries develops a keloid. Some people are simply more likely to form them because of genetic and other factors. Having a close family member with keloids can also increase the likelihood of developing them.
Where Do Keloids Commonly Appear?
Keloids can develop anywhere on the body, but some areas are more commonly affected than others.
Common locations include:
- Earlobes
- Chest
- Shoulders
- Upper back
- Neck
- Jawline
- Arms
Keloids on the earlobes are particularly common after ear piercing.
Keloid vs. Hypertrophic Scar: What Is the Difference?
Keloids are sometimes confused with hypertrophic scars because both can appear raised.
The main difference is that a keloid can grow beyond the original wound, while a hypertrophic scar generally remains within the boundaries of the original injury.
Hypertrophic scars may also become less noticeable with time, whereas keloids usually persist without treatment.
If you are unsure which type of scar you have, a dermatologist can examine it and determine the most appropriate treatment.
Are Keloids Dangerous?
Most keloids are benign and do not pose a serious health threat. However, they can cause symptoms such as itching, pain, tenderness, or discomfort.
A keloid located close to a joint can occasionally interfere with movement. In addition, a rapidly changing or unusual skin growth should not automatically be assumed to be a keloid. A healthcare professional may need to examine it to rule out other skin conditions.
How Are Keloid Scars Treated?
There is no treatment that permanently removes every keloid or guarantees that it will never return. The best option depends on the size, location, age, symptoms, and previous treatment of the scar.
A dermatologist may recommend one treatment or combine several approaches.
1. Corticosteroid Injections
Corticosteroid injections are among the commonly used treatments for keloids. A dermatologist injects medication directly into the scar to help reduce its size and soften it.
Several treatment sessions may be necessary. Many keloids shrink after corticosteroid injections, although some can grow back later.
Possible side effects can include skin thinning and changes in skin color. Treatment should therefore be performed by a qualified healthcare professional.
2. Silicone Gel or Silicone Sheets
Medical-grade silicone gel and silicone sheets may help flatten a keloid and can also be used as part of scar prevention after a wound has healed.
Silicone products should not be placed over an open wound or scab. The American Academy of Dermatology recommends using silicone after the injured skin has healed.
Silicone treatment is generally considered a non-invasive option, but results can take time and may vary.
3. Cryotherapy
Cryotherapy, sometimes called cryosurgery, uses extreme cold to freeze the keloid tissue.
It may reduce the size and hardness of smaller keloids. More than one treatment may be needed.
One important consideration is skin-color change. Cryotherapy can cause lighter areas of skin, and this effect may be more noticeable in people with darker skin tones.
4. Laser Treatment
Laser therapy may help reduce the height or redness of some keloids. It is often combined with other treatments, such as corticosteroid injections.
Laser treatment can require several sessions, and the choice of laser depends on the characteristics of the scar and the patient's skin.
5. Pressure Therapy
Pressure dressings, compression garments, or specially designed pressure earrings may be recommended, particularly after treatment of an earlobe keloid.
The purpose is to apply consistent pressure to the area and reduce the chance of the keloid returning. However, pressure devices may need to be worn for many hours each day over an extended period, so following the dermatologist's instructions is important.
6. Surgery
Surgical removal involves cutting out the keloid. Although this may appear to be a straightforward solution, surgery alone has a significant risk of recurrence.
For that reason, doctors may combine surgery with another treatment, such as corticosteroid injections, pressure therapy, silicone treatment, or cryotherapy.
Surgery should therefore be considered as part of an overall treatment plan rather than as a guaranteed permanent solution.
7. Radiation Therapy
Radiation therapy may sometimes be used after surgical removal to reduce the chance of a keloid returning. However, it is not suitable for everyone and has potential risks and side effects.
Because of these considerations, radiation is generally reserved for selected cases under specialist medical supervision.
Can You Treat a Keloid Naturally?
There is no proven natural remedy that can reliably remove a keloid.
Some non-prescription products are marketed for scar treatment, but evidence for ingredients such as onion extract, vitamin E, and similar products is limited. It is better to discuss any product with a dermatologist before applying it to a persistent or unusual scar.
Avoid attempting to cut, pierce, burn, or squeeze a keloid yourself. Additional skin trauma can cause further scarring.
How Can You Reduce the Risk of Keloids?
If you are prone to keloids, preventing unnecessary skin injuries can be particularly important.
After an injury, proper wound care can help support normal healing. Gently clean the wound and keep it appropriately covered. Once the wound has healed and the skin is no longer open, silicone gel or silicone sheets may be considered to help reduce the risk of a keloid.
People who have previously developed keloids may also want to discuss elective piercings, tattoos, and other procedures that intentionally injure the skin with a healthcare professional beforehand.
Treating acne early may also help reduce the risk of acne-related scarring.
When Should You See a Dermatologist?
Consider seeing a dermatologist if:
- A scar continues to grow.
- The area becomes painful or very itchy.
- The scar interferes with movement.
- You are unsure whether the growth is actually a keloid.
- The scar developed without an obvious injury.
- Previous treatments have not worked.
- You want to remove or reduce the appearance of the scar.
A dermatologist can usually diagnose a keloid by examining the skin. In some cases, additional testing such as a skin biopsy may be needed when the diagnosis is uncertain.
Frequently Asked Questions
Do keloids go away on their own?
Usually, no. Unlike some other scars, keloids generally do not fade significantly without treatment. Medical treatment can make them less noticeable and reduce symptoms.
Can a keloid come back after treatment?
Yes. Recurrence is one of the main challenges when treating keloids. This is why dermatologists may combine different treatments rather than relying on surgery or another single treatment alone.
Can I remove a keloid at home?
You should not attempt to cut, pierce, freeze, or otherwise physically remove a keloid yourself. Treatment should be selected according to the type and location of the scar.
Are silicone sheets useful for keloids?
Silicone sheets may help flatten some keloids and can also be used after a wound has healed as part of scar prevention. They are not a guaranteed cure, however.
Is surgery the best treatment?
Not necessarily. Surgery can remove a keloid, but the scar may return afterward. Doctors often combine surgery with another treatment to reduce the risk of recurrence.
Final Thoughts
Keloid scars can be frustrating because they may continue growing after the original injury has healed. Although they are generally harmless, they can cause itching, pain, discomfort, or cosmetic concerns.
Several treatments are available, including corticosteroid injections, silicone products, cryotherapy, laser therapy, pressure therapy, and surgery. The most appropriate option depends on the individual case, and combining treatments may provide better results for some people.
If you have a growing or unusual scar, it is best to have it assessed by a qualified healthcare professional rather than relying on home remedies or trying to remove it yourself.