Keloids are a type of scar that are raised and may grow larger than the original wound . They may form immediately after a wound heals or after it has healed. Although they are not harmful, they can be painful, itchy, irritating, or have cosmetic implications.
However, treating keloids early is important to prevent them from getting bigger and affecting your appearance and confidence. There are several ways to treat keloids, including self-care and medical treatments.
Causes of keloids
Keloids are the result of a disruption in the body’s natural wound healing process. Normally, when the skin is damaged or wounded, it creates new tissue and collagen to repair the area and heal. However, if this process is overactive, it can cause scarring. Most scars gradually fade over time, but keloid scars are larger and more raised than the original wound.
Keloid scars form after receiving any type of trauma to the skin, such as:
- Surgical wound
- Body piercingwounds
- Burns
- Chickenpoxand acne scars
- A minor scratch can leave a scar like this, but keloids that form after minor injuries take years to develop.
- Keloids can occur naturally in the center of the chest, even if there has been no previous injury or wound in that area.
Keloids can happen to anyone, but people between the ages of 10 and 30 are more likely to get them. It is believed that genetics may play a role, as more than half of people who develop keloid scars have family members who have also had keloids.
Symptoms of Keloid
Keloids can occur anywhere on the body, but areas more likely to develop keloids include the chest, shoulders, back, neck, and earlobes. They may have the following noticeable characteristics:
- It is a lump that protrudes from the skin and gradually grows larger over time.
- The appearance is shiny and there is no hair growing on the keloid.
- It may initially appear red or purple before gradually turning darker or paler.
- When touched, it feels hard and rubbery.
- It is not painful, but some people may experience pain, bruising, itching, burning, or difficulty moving if it affects the joints.
- When touched or rubbed against clothing, irritation, itching, or pain may occur.
- Keloids can persist for years, and sometimes take months or years to form.
- When exposed to sunlight, it may appear darker than the surrounding skin, and it is possible that the darkening may not go away.
Keloid symptoms that require seeing a doctor
Keloids are usually harmless and do not require treatment. However, their appearance can be unsightly and can affect your self-confidence. However, if you experience pain or itching that interferes with your daily life, you should see a doctor.
Keloid Diagnosis
The doctor will examine the abnormality with the naked eye to distinguish keloids from tumors or other types of scars that may look similar, such as hypertrophic scars , which are similarly raised and can sometimes cause confusion.
Hypertrophic scars differ from keloids in that they are usually redder in color than keloids and will gradually fade on their own, which may take a year or more. Hypertrophic scars form within two months of injury and grow rapidly within six months. After two to three years, they gradually shrink and become stable. They are most commonly found in areas with high skin tension, such as the shoulders, neck, knees, and ankles.
However, to help confirm for sure whether a scar is a keloid, hypertrophic scar or skin tumor, your doctor may take a biopsy of the abnormal area and examine it under a microscope for differences, which in the case of a keloid will show specific cells.
Keloid treatment
Here are some ways to treat keloids:
- Take care of your wound yourself.
Wound treatment to help prevent keloids from forming can be done as follows:
Cover the wound when it occurs.
Closing the wound will help create pressure and protect the keloid from air exposure. Cover the wound with a bandage, then use tape to hold the bandage or gauze in place to create pressure on the wound. Cover the scar area with tape, which should be kept on for 12–24 hours a day for at least 4–6 months.
The area should be cleaned with soap and water every day. If you have pierced ears , use earlobe patches. If used correctly, they can help shrink keloids from ear piercings.
Use ointment or silicone gel.
After the wound has healed, apply a silicone gel sheet to press on the area to prevent scar growth. Cover it for 12–24 hours a day for 2–3 months, as keloid scars take about 3 months to form.
In addition, applying Imiquimod cream after any surgery may help prevent scarring or reduce the chances of new keloids forming after surgery.
Protect the wound area from sunlight.
When exposed to sunlight, protect the wound with a bandage, plaster, or sunscreen. Do this for 6 months after the wound or surgery.
- Keloid treatment by a doctor
Several medical treatments may help treat keloids, including:
Use of retinoids
Retinoids are often used to treat keloid scars caused by acne. Applying retinoids to the scar can help improve the condition, but this treatment is not as popular as other treatments.
Corticosteroid injections
Corticosteroid injections are a safe and painless treatment that are given every 4 to 8 weeks to help shrink the keloid. However, they can cause the scar to become redder as a side effect, as they stimulate the area to produce more blood vessels close to the surface.
Although this treatment may improve the appearance of the scar, it may still be visible in comparison to the surrounding skin.
Laser
Using a gentle laser (Pulsed Dye Lasers) can help flatten and reduce redness of keloid scars. It is a safe and painless treatment, but it can require multiple treatments and is quite expensive.
Cryotherapy
This treatment is used for small wounds by applying high temperatures from liquid nitrogen. The use of extreme cold will help flatten the keloid. If treatment is started early, there is a chance of stopping the growth of the keloid. Other methods of treatment may be used in conjunction, such as steroid injections. However, this method has a side effect of making the treated area of skin darker or lighter.
Injections that help shrink keloids
Interferon injections are a type of protein produced by the body’s immune system to help eliminate viruses, bacteria, germs, and other foreign substances. Interferon injections can indeed help reduce the size of keloids, although it is not yet known whether the results are long-lasting.
Currently, there are studies on the use of interferons in other ways besides injecting them into the keloid, such as imiquimod, which stimulates the body to produce interferons in that area.
In addition, injections of the anticancer drugs fluorouracil and bleomycin have been used to slow the formation of keloids, and may be used in conjunction with steroid injections. However, these drugs can cause side effects such as causing the keloid to become sore, discoloring the skin, or damaging the skin.
Surgery
Surgery is another option for treating keloids. It involves cutting away the skin in the keloid area. However, this surgery is considered a risky procedure because it can cause the scar to become raised or larger than before.
Doctors often use other methods of treatment after surgery, such as applying compression patches or silicone gel sheets to the wound for 12–24 hours a day for several months, steroid injections, and radiation therapy. In addition, using as few stitches as possible after surgery may also help reduce the chances of scarring.
Radiation
Radiation is often used as a last resort in the treatment of keloids because of its potential for cancer. It is used only when necessary to treat parts of the body that are far from internal organs, such as an arm or leg. It is not used for keloids in the abdomen or chest.
Alternatively, close-range radiation therapy may be used, in which radioactive material is placed directly or near the keloid area, similar to treating tumors or cancer, to help shrink the keloid after surgery.
However, various methods of treating keloid scars may only help improve the appearance of the keloid or make it less irritating, and there is still a chance that the keloid will grow back after treatment.
Complications of keloids
In addition to being unsightly and affecting confidence, some keloid scars may develop into pus , or if the wound is large and occurs in a joint, it may make movement difficult and may hinder growth in children.
Keloid prevention
Those who notice that they are likely to develop scars after a wound has healed should avoid tattooing, body piercing , or any unnecessary surgical procedures, as all of these increase the risk of keloids. Additionally, if any wounds occur on the body, they should be treated immediately to speed healing and reduce the chances of scarring.
