KELOIDS

General Information

DEFINITION--An overgrowth of fibrous tissue (scar) on the skin. They usually arise in an area of injury (such as after a burn or from severe acne), but sometimes arise from a very minor scratch. Keloids are more frequent in black people than in white people.

BODY PARTS INVOLVED--Anywhere on the skin, but most commonly appear on the breastbone, upper back and shoulder.

SEX OR AGE MOST AFFECTED--Both sexes; all ages.

SIGNS & SYMPTOMS

• Firm, raised, hard scars that are slightly pink.
• Scars may itch, cause pain or be tender to the touch.
• Scars may continue to grow and develop claw-like projections over a period of time.

CAUSES--Keloids occur due to a defective healing process in which an excess of collagen forms at the site of a healing scar.

RISK INCREASES WITH

• Family history of keloids.
• Dark skin pigment.
• Surgical wound.
• Acne.
• Burn injury.
• Ear piercing.
• Vaccination.
• Insect bite.
• Folliculitis barbae (inflammation of a hair follicle).

HOW TO PREVENT

• Avoidance of trauma to the skin.
• Compressive pressure dressings for high-risk patients (burns).
• For patients with known tendency to keloid formation, elective surgery should be avoided. If a procedure is necessary, special precautions should be implemented.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.

APPROPRIATE HEALTH CARE

• Patients often want scars removed for cosmetic and functional reasons including itching, swelling and restrictions of movement.
• Injections (may be combined with surgical removal of the excess tissue) for some patients.
• Cryosurgery (See Glossary) using nitrous oxide and liquid nitrogen. Treatment may be repeated (every 30-60 days) until no further improvement is observed.
• Other experimental therapies with drugs, lasers, topical medications are currently undergoing study.

POSSIBLE COMPLICATIONS--Recurrence, despite adequate treatment.

PROBABLE OUTCOME--Scars gradually diminish following treatment. Keloids are generally considered harmless and noncancerous.

How To Treat

GENERAL MEASURES----There is no self-treatment for keloids. Follow doctor's instructions for follow-up measures after treatment.

MEDICATION--Injection of corticosteroid drugs directly into the keloid. May be repeated every three to four weeks until desired degree of flattening and softening has been achieved.

ACTIVITY--No restrictions.

DIET--No special diet.

Call Your Doctor If

You have signs of keloids.