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Medical Dermatology

Keloids Scars

What causes a scar?

A scar can result from trauma to the skin, such as those from surgical wounds, chicken pox, insect bites, injection sites, burns, blisters, acne, piercings, or tattoos. Genetics, age, skin color and medications can affect how you heal.

How is a scar formed?

When your skin is injured, the body attempts to repair the wound by depositing collagen around the wound in an effort to seal and protect it from future injury. In normal wound healing, scar formation and maturation can take several months. The scar tissue is tougher and less flexible than the normal skin tissue. Over time, the scar matures, changing from red to pink and then fades, becoming less and less noticeable. 

What are keloid Scars?

Keloids are a type of raised scar composed of excessive scar tissue that develops at the site of a skin injury, regardless of the cause. However, in contrast to normal scar formation, keloid scars do not stop growing and can invade healthy tissue beyond the area of the original wound. Additionally, keloid scars can develop up to a year after surgery or injury. Keloids can affect a patient’s self-esteem and quality of life.

What are the characteristics of a keloid?

  • A keloid grows slowly over months but may not be obvious for up to a year. Sometimes they can continue to grow for years.
  • In keloids , the scar tissue continues to form after the wound heals creating a much larger scar than the original injury.
  • A keloid is raised with a flat surface and can be red, pink, purple or dark brown. Over time, the color will darken with a border that is darker than the center. If exposed to the sun, the color can become darker than the surrounding skin.
  • A keloid can feel firm and tough or soft, doughy and shiny.
  • A keloid scar can be painful, sensitive to touch, and cause severe itching, but once the scar has matured these symptoms subside.

Is my scar a hypertrophic scar or keloid?

Hypertrophic scars are the result of excessive scar tissue like keloid scarring. They are raised and shiny, thick and red, and may take 2-3 months to develop after a wound. They may also itch or be painful. However, hypertrophic scars do not extend beyond the boundary of the wound, and they usually improve over time.

What causes keloids?

We inherit our scar forming qualities from our parents. Keloids run in families. The main cause of keloid formation is excessive tension on the wound. Keloids develop on the surface of the skin in areas, like the neck, chest, trunk, back, face and ears where there is tension on the wound.

Who is at risk for keloid Scars?

Keloids are common in people, ages 10 to 30 years. They are also common in puberty, and pregnancy. People with darker skin types are seven times more likely to develop keloids.

How are keloid scars treated?

Once a keloid forms it is permanent unless removed or treated. However, even though treated or removed, a keloid scar often grows back.

The goal of treatment is to flatten, soften and shrink the keloid scar, and it may take a combination of treatments. The choice of treatment will depend on the patient and the size and location of the keloid.

Steroid injections can help shrink the scar. Cryotherapy may be beneficial for small scars or keloids. Laser therapy can fade the color and flatten the scar.

Large keloids can be removed with surgery. However, surgery itself can cause formation of a new keloid. Maintaining pressure on the wound after surgery and applying silicone bandages or sheets can help keep the keloid from recurring. Your board-certified dermatologist may even recommend radiation therapy in combination with the aforementioned treatments.

When you are suffering with a keloid or a hypertrophic scar, contact Phoenix Surgical Dermatology Group in Phoenix, AZ. Schedule a consultation with a board-certified dermatologist and learn about your treatment options.

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