What Are Keloid Scars?

A wound usually leaves a scar following its healing process. A keloid is also a kind of scar. Keloid scars grow too much and usually become larger compared to the original wound. They are characterised by hard nodules with smooth surfaces because of excessive production of a protein called collagen. Keloids may occur spontaneously or follow a skin trauma or surgery. They are generally itchy.

Sometimes, scars can achieve a little lumpy appearance. This process is known as hypertrophy.

Keloid scars differ from hypertrophic scars in several ways. They are:

• Unlike hypertrophic scars, which diminish within one year, keloid scars are long-lasting and may continue to become larger.
• Keloid scars spread beyond the original margin of skin damage.
• Keloid scars can occur following very minor skin trauma, like acne. Sometimes, they appear without obvious trauma to the skin at all.

Keloids are likely to affect younger adults and are common among black Africans. There may be a tendency to have keloids, which runs in certain families (hereditary).

Symptoms and signs

Normally, there are no significant symptoms. Sometimes, they can be painful, tender, itchy, or result in a burning sensation. Keloids seem like extended scars, which spread beyond the original area of the skin trauma. They are elevated over the skin surface, and sometimes they can be domed. Usually, they are hairless and shiny. If you touch a keloid, you will feel rubbery and hard. Newer keloid scars are normally purple or red. They become browner or sometimes paler, when they get older. However, their appearance can cause embarrassment. Sites of predilection are the chest, upper back, shoulders, chin, and earlobes. Most individuals with this condition have just one or two keloids. However, some individuals have many, particularly if they appear following chickenpox scars or acne. Some very tight keloids can also restrict movements of nearby joints.

Diagnosis

There is no specific investigation to diagnose keloid scars. Your doctor can make the diagnosis simply by looking at the skin.

Treatments

It is very difficult to cure keloid scars. Treatments include compression with silica gels, triamcinolone injection, or surgical removal. However, surgery must be followed by superficial radiotherapy or steroid injection, because they can suppress the keloid formation later in the same location. Otherwise, surgery can make the condition worse than before.



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