Keloids Q & A

What are Keloids?

Keloids are raised, red or deep purple scars that can occur at the site of an injury, such as a scrape, burn or cut. Unlike a typical scar, keloids are larger than the original injury. They are smooth and hard to the touch. Although they can occur anywhere on the body, keloids are most commonly found on the cheeks, earlobes, shoulders or chest. The size of a keloid can vary greatly, from that of a sunflower seed to a softball.

Keloids do not appear right away. They typically emerge about three months after the injury and can take more than a year to fully develop. Keloids can continue to grow for years after they first appear, causing physical and emotional distress. A keloid is harmless to general health and does not change into skin cancer. They will stop growing eventually; however, they will not disappear without intervention from a skilled dermatologist, such as those at Aspire Skin Center & Aesthetics.

What causes Keloids?

Most people get these scars after they injure their skin, such as from:

·       Cut or puncture wound

·       Tattoo or piercing

·       Surgical scar 

·       Some women who have had a cesarean section (C-section) or hysterectomy surgery. 

·       Acne scars or chickenpox marks

·       Insect bite or shot for a vaccine

·       Wearing tightly braided hair 

·       Men who shave their face develop keloids in their beard area. 

·       It’s also possible for keloids to form on uninjured skin. These keloids are called “spontaneous keloids.” They usually appear on the chest.

 

It’s still not clear why some people’s skin scars this way. You’re more likely to develop a keloid if you have one or more of the following: African, Asian, or Hispanic descent, family history of keloids, between 10 and 30 years of age.

How are Keloids treated?

A hypertrophic scar generally settles in time or with treatment, but a keloid may persist and prove resistant to treatment. The following measures are helpful in at least some patients. 

Injections of corticosteroids and other medicines: These injections are often part a treatment plan for keloids. When injected into the keloid, these medicines help to shrink the scar. Patients usually receive a series of injections once every three to four weeks. On average, patients return about four times for these injections. The first injections tend to relieve symptoms and make the keloid feel softer. Between 50% and 80% of keloids shrink after being injected. Many of these keloids, however, will regrow within five years. To improve results, our dermatologists at Aspire Dermatology & Aesthetics often add another therapy to the treatment plan.

Surgical removal (keloid surgery): This treatment involves surgically cutting out the keloid. While this may seem like a permanent solution, it’s important to know that nearly 100% of keloids may return after this treatment. To reduce the risk of a keloid returning after surgical removal, our dermatologists at Aspire Dermatology & Aesthetics often treat patients with another keloid treatment during or after the surgery. Injections of corticosteroids or cryotherapy may help reduce the risk. If the keloid is on an earlobe, wearing a special earring that puts pressure on the earlobe can prevent the keloid from returning. Receiving radiation treatments after surgical removal may also prevent a keloid from returning. At Aspire Dermatology & Aesthetics, our board certified dermatologist and dermatology physician assistant are skilled in the surgical removal of keloids.

Pressure earring, dressing, or garment: This is often used after keloid surgery. Putting pressure on the area reduces blood flow, which can stop a keloid from returning. Between 90% and 100% of patients who use this treatment as directed after keloid surgery can prevent another keloid. Using this as directed, however, can be difficult. These devices tend to be uncomfortable. To get results, a patient must wear it for up to 16 hours a day for 6 to 12 months. The pressure earring tends to be easiest to wear. It is often recommended after a dermatologist removes a keloid from an earlobe.

Laser treatment: This can reduce the height and fade the color of a keloid. It’s often used along with another treatment like a series of corticosteroid injections or pressure. At Aspire Dermatology & Aesthetics, our Intense Pulse Light (IPL) laser can effectively improve the size and appearance of hypertrophic scars and keloids.

Cryotherapy: This treatment freezes the keloid from the inside out while saving the skin beneath the keloid. It’s used to reduce the hardness and size of a keloid. Cryotherapy works best on small keloids. Having a few cryotherapy treatments before (or after) receiving injections of corticosteroids may reduce the size of a keloid. This can make the injections more effective.

Radiation treatments: Getting radiation therapy after your dermatologist surgically removes the keloid and may prevent the keloid from returning. Patients may begin radiation treatments immediately after keloid surgery, the next day, or a week later. Radiation may also be used alone to reduce the size of a keloid. Results, however, tend to be better when it’s used after keloid surgery.

Keloid Treatment at Aspire Dermatology & Aesthetics

Treatment can reduce the size of keloid. It can reduce symptoms like pain and itch. Sometimes, treatment gets rid of a keloid. Even after successful treatment, some keloids return. Following your dermatologist’s instructions can help you reduce the chance of a keloid returning. It will also help you get the best results from treatment.

To explore treatment options for Keloids, we welcome you to schedule an appointment at Aspire Dermatology & Aesthetics. Call the office or book a consultation online today.