Keloid

Overview, Causes, & Risk Factors

A keloid is a patch of excessive scar tissue that may form following a skin injury.

What is going on in the body?

Keloids generally form after a skin injury heals. For unknown reasons, some people produce an excess of dense, fibrous tissue at and around the site of injury. A keloid is abnormal because the scar extends above and beyond the site of the original injury. Normal scars stay confined to the site of injury.

What are the causes and risks of the condition?

The exact cause of keloids is unknown. They do run in families, however, and are associated with certain abnormal genes. Other risk factors for keloids include the following:

age between 10 and 30

Polynesian, Chinese, and black African ethnic backgrounds

type A blood
Keloids are associated with skin healing after injury. Some events associated with keloid formation include the following:

accidental injuries, such as gunshot wounds

piercing of body parts, such as the earlobes and abdomen

surgery

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Symptoms & Signs

What are the signs and symptoms of the condition?

Keloids are thick, smooth areas of pink scar tissue. The scar tissue is raised above the level of the surrounding skin. Some keloids are itchy or tender.
Keloids can occur on any skin area. The most common locations for keloids vary according to race. In Caucasians, for example, keloids are most common on the face and arms. Blacks tend to develop keloids most often on the face and legs.

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Diagnosis & Tests

How is the condition diagnosed?

Keloids are diagnosed by their appearance.

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Prevention & Expectations

What can be done to prevent the condition?

Persons who tend to develop keloids should avoid cosmetic procedures to their skin. If surgery is necessary, an injection of cortisone can be made into the skin first. This may lower the risk of developing a keloid.

What are the long-term effects of the condition?

Keloids may be cosmetically embarrassing. However, they cause no long-term health problems.

What are the risks to others?

Keloids are not contagious and pose no risk to others.

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Treatment & Monitoring

What are the treatments for the condition?

Treatment of keloids can include:

compression of the earlobe between two buttons after the keloid is removed surgically

corticosteroids injected directly into the keloid

cryosurgery, which involves freezing the keloid with liquid nitrogen

interferon medicines, which interfere with formation of excess skin

laser surgery to cut out the keloid

radiation therapy to remove the keloid

silicone gel dressings

surgical removal of the keloid

What are the side effects of the treatments?

Surgery may cause bleeding, infection, or allergic reaction to anesthesia. Surgical removal of a keloid may also cause an even larger keloid to form.

What happens after treatment for the condition?

Keloids may continue growing for many years. Keloids do not disappear or become normal in size. Over time, however, they usually flatten and become less pink and obvious.

How is the condition monitored?

Any new or worsening symptoms should be reported to the healthcare provider.

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Attribution

Author:Lynn West, MD
Date Written:
Editor:Crist, Gayle P., MS, BA
Edit Date:04/30/01
Reviewer:Eileen McLaughlin, RN, BSN
Date Reviewed:08/20/01