A keloid scar is a disfiguring scar that heals beyond the surface of the original wound. Put simply when the skin is damaged cells grow back to fill the gap. In normal wound healing the cells know when the job is done and stop, leaving a flat scar, which sits level with the skin surface.
A keloid scar forms when the cells do not know when to stop and continue to enlarge beyond the original shape or boundaries of the wound. In appearance keloid scars are always raised above the level of the rest of the skin. They are often dome shaped and may range in color from slightly pink through to red. The scar will also feel hard and thick.
A keloid scar may be asymptomatic but it is more common for them to be tender and itchy. These symptoms may continue for many years.
More common in young people with black skin
Keloid scars are 5 – 15 times more likely to develop in people with black skin than they are in people with light colored skin. They are also more prevalent in people between the ages of 10 – 30 years. The growth of a keloid scar will often increase during puberty and pregnancy and slow down or stop during and after menopause. This leads to the belief that hormones are involved in the development of keloid scars.
People of any skin type can develop a keloid scar however they are more common in those with a family history of the scar.
Difficult to treat
Treatment of keloid scars is often difficult. Surgically removing the scar is often not advised, as the possibility of another keloid scar (probably larger) growing back in its place is quite high.
Non-surgical intervention is therefore the treatment of choice. Injections of cortisone can often significantly reduce the size and redness of the scar especially if used in the early stages of the keloid development.
Pressure applied via thromboembolic stockings, elastic bandages or custom fitting garments are thought to decrease tissue metabolism and increase collagen breakdown within the wound. Silicone gel or sheeting is also a newer popular form of treatment.
Despite the many forms of treatment available it is not possible to completely remove or cure a keloid scar. Most treatments aim at a reduction in size and a lessening in itchiness and discomfort.