Keloids can be considered as “scars that don’t know when to stop.” A keloid, often describe as a tough heaped-up scar that rises quite abruptly above the rest of the skin. It usually has a smooth pink or red colour surface. Keloids are irregularly shaped and tend to enlarge progressively. Unlike scars, keloids do not regress over time.
What is the difference between a keloid, hypertrophic scar?
After skin injury, the healing process usually leaves a flat scar. Sometimes the scar is hypertrophic, or thickened, but confined to the margin of the original wound. Hypertrophic scars tend to be redder and often regress spontaneously.
Keloids, by contrast, may start sometime after a cutaneous injury and extend beyond the wound site. This tendency to migrate into surrounding areas that weren’t injured originally distinguishes keloids from hypertrophic scars. Keloids typically appear following surgery or injury, but they can also appear due to some minor inflammation, such as an acne pimple on the chest.
What are keloid symptoms and signs?
Keloids are raised, shiny and dome-shaped, ranging in colour from pink to red. Some keloids become quite large and unsightly. Aside from causing potential cosmetic problems, these exuberant scars tend to be itchy, tender, or even painful to the touch.
What are treatment options for keloids?
Corticosteroid injections (intralesional steroids): These are safe but moderately painful. Injections are usually given once every four weeks into the keloids and usually help flatten keloids. The keloid may look better after several treatments but even the best results leave a mark that looks and feels quite different from the surrounding skin.
Silicone gel or sheeting: This involves wearing a sheet of silicone gel on the affected area continuously for months, which is hard to sustain. The results are variable.
Surgery: Reoccurrence is high because cutting a keloid can trigger the formation of a similar or even larger keloid. Some surgeons achieve success by injecting steroids or applying compression to the wound site for several months after removing the keloid.