Keloid scars

What are keloid scars?

When the skin is broken – for example, by a cut, bite, scratch, burn, acne or piercing – the body produces more of a protein called collagen.

Collagen gathers around damaged skin and builds up to help the wound seal over. The resulting scar usually fades over time, becoming smoother and less noticeable.

But some scars don't stop growing, invading healthy skin and becoming bigger than the original wound. These are known as keloid scars, which affect around 10-15% of all wounds.

Keloid scars are more common on the upper chest, shoulders, head (especially the earlobes) and neck, but they can happen anywhere.

They're normally:

• shiny
• hairless
• raised above surrounding skin
• hard and rubbery
• red or purple at first, before becoming brown or pale

They can last for years, and sometimes don't form until months or years after the initial injury.

They're usually painless, but some can cause:

• pain
• tenderness
• itchiness
• a burning feeling
• limited movement if located on a joint

Some people feel embarrassed or upset if they think the scar is disfiguring them.

Experts don't fully understand why keloid scarring happens. They are not contagious or cancerous.

Keloid scars can sometimes develop after minor skin damage, such as burns, acne scars and even chicken pox, but they can sometimes happen spontaneously with no history of skin trauma. If you've had a keloid scar before, you're more likely to get another.

Who gets keloid scars?

Keloid scars can affect anyone, but they're more common in people with dark skin and it's thought they may run in families. Younger people between the ages of 10 and 30 are more likely to develop them.

Can you prevent keloid scars?

You can't completely prevent keloid scars, but you can avoid any deliberate cuts or breaks in the skin, such as tattoos or piercings, including on the earlobes.

Treating acne will reduce the likelihood of acne scars appearing. Avoid minor skin surgery to areas more prone to keloid scarring – the upper chest, back and upper arms – if possible.

Treatments for keloid scars

There are several treatments available, but none have been shown to be more effective than others. Treatment can be difficult and isn't always successful.

Treatments that may help flatten a keloid include:

• steroid injections
• applying steroid-impregnated tape for 12 hours a day
• applying silicone gel sheeting for several months

Other options include:

• freezing early keloids with liquid nitrogen to stop them growing
• laser treatment to reduce redness – but this won't make the scar any smaller
• surgery, sometimes followed by radiotherapy, to remove the keloid – although the keloid can grow back and may be larger than before

If you're bothered by a keloid scar and want help, see your GP.