Reference Index - Disease & Conditions

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Keloid above the ear
Keloid above the ear


Keloid, pigmented
Keloid, pigmented


Keloid, on the foot
Keloid, on the foot


Keloids

Definition:

Keloids are the excess growth of scar tissue at the site of a healed skin injury.



Alternative Names:

Hypertrophic scar; Keloid scar; Scar - hypertrophic



Causes, incidence, and risk factors:

Keloids occur from such skin injuries as:

  • Acne
  • Burns
  • Chickenpox
  • Ear piercing
  • Minor scratches
  • Surgical cuts
  • Traumatic wounds
  • Vaccination sites

They are fairly common in young women and African Americans. Keloids often run in families. Keloidosis is a term used when many or repeated keloids occur.



Symptoms:

A skin lesion that is:

  • Flesh-colored, red, or pink
  • Located over the site of a wound or injury
  • Lumpy (nodular) or ridged

The lesion may itch while it is forming and growing.



Signs and tests:

Diagnosis is based on the appearance of the skin or scar. A skin biopsy may be needed to rule out other skin growths (tumors).



Treatment:

Keloids often do not need treatment. They may be reduced in size by:

  • Corticosteroid injections
  • External pressure
  • Freezing (cryotherapy )
  • Laser treatments
  • Radiation
  • Surgical removal


Support Groups:



Expectations (prognosis):

Keloids usually are not medically dangerous, but they may affect the appearance. In some cases, they may become smaller, flatter, and less noticeable over a period of several years.

Exposure to the sun during the first year after the keloid forms will cause the keloid to tan darker than the skin around it. This dark color may be permanent.

Removing the keloid may not be permanent. Surgical removal may cause a larger keloid scar.



Complications:
  • Cosmetic changes that affect the appearance
  • Discomfort, tenderness of the keloid
  • Irritation from rubbing on clothing or other forms of friction
  • Limited mobility (if the keloids are extensive)
  • Psychological distress if the keloid is large or disfiguring
  • Return of the keloid


Calling your health care provider:

Call your health care provider if:

  • You develop keloids and want to have them removed or reduced
  • You develop new symptoms


Prevention:

You can prevent discoloration from sun exposure by covering the forming keloid with a patch or Band-Aid, and by using sunblock when spending time in the sun. Continue these extra protection measures for at least 6 months after injury or surgery for an adult, or up to 18 months for a child.

Imiquimod cream has recently been used to prevent keloids from forming after surgery, or to prevent keloids from returning after surgery to remove them.




Review Date: 10/3/2008
Reviewed By: Kevin Berman, MD, PhD, Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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