Keloids

Dark skinned people get keloids much more easily than those with a paler skin. They are especially common in people with black skin.

Keloids can crop up anywhere but do so most easily on certain areas, such as the skin around the upper chest and shoulders - particularly over the breastbone (sternum) - and on the earlobes.

Wounds that are under tension while healing, or which get infected, are particularly likely to form keloids, as are burn and acne scars.
Keloids are most common between the ages of 10 and 30 years.
Keloids are not caught from someone else and carry no risk of turning into a cancer.

Are keloids hereditary?
They can be - a tendency to get keloids certainly runs in some families.
What are the symptoms of a keloid?
Usually there are none; but some are tender, painful, itchy, or cause a burning sensation. The main problem is that their appearance may cause embarrassment. If they are very tight, they can limit movement at nearby joints.

What does a keloid look like?
Keloids look like exaggerated scars. They are raised above the skin around them and sometimes they are domed. They can extend beyond the limits of the skin damage that caused the scar to come up in the first place. They are shiny and hairless; usually they feel hard and rubbery; and new ones are often red or purple, becoming browner and sometimes paler as they age. Most people with keloids have only one or two. However some people have many, especially if they have come up after acne or chickenpox scars.

How will it be diagnosed?
Your doctor will be able to make the diagnosis of a keloid just by looking at your skin. No investigations are usually needed.

Can a keloid be cured?
It is unusual for a keloid to be cured after treatment. The main problem is that cutting a keloid out often leads to an even bigger one forming later in the same place.

How can a keloid be treated?
Treatment is difficult and not always successful. Possible lines of treatments include the following:

Injections of a steroid (triamcinolone) into a keloid may help to flatten small early ones.

Freezing with liquid nitrogen may also stop early keloids from growing.

Putting a silicone sheet over them at night for several months helps some keloids to flatten. Long-term compression with pressure bandages sometimes helps too.

Laser treatment makes keloids less red, but does not make them smaller.

If a keloid is cut out, it usually comes back, and may end up larger than it was before. This risk falls if the area is treated after the operation with pressure dressings or local steroid injections

What can I do?
With keloids, prevention is better than cure. You have an extra risk of getting a keloid if:

You have had a keloid before.
Members of your family have had them.
You have a dark skin.

If you are at risk, you should avoid tattoos or body piercing, particularly if these would go through one of the high-risk areas of skin, such as the ear lobes. If you have acne, see your doctor to make sure it is treated vigorously to limit the risk of scarring. You should avoid having skin surgery for cosmetic purposes.

While every effort has been made to ensure that the information given in this leaflet is accurate, not every treatment will be suitable or effective for every person. Your own doctor will be able to advise you in greater detail