What are Keloids?

Keloids are a special type of scars which are created due to an uncontrolled creation of connective tissue and collagen fibers after a skin injury or during the healing of the wounds. Keloids behave as benign tumors, whose cells divide uncontrollably. This is why they can be found in the places where tissue is damaged, but they go over the boundaries of the wound itself and spread to the surrounding tissue. This tendency of keloids to spread to the surrounding areas of the skin which wasn’t injured in the first place differentiates keloids from hypertrophic scars which are on the very borders of the wound.

How do Keloids appear?

Keloids usually appear after surgical interventions, inflammatory processes, cuts, chemical and thermal skin injuries, acne, measles piercings and similar. Cases of spontaneous keloid appearance, without previous trauma, have been recorded. It is considered that there is a genetic predisposition for the occurrence of keloids, but the genetic foundation itself hasn’t been found yet. Keloids are somewhat more frequent in women, between their twenties and thirties and are less common in children and elderly.

Where do Keloids appear most commonly?

Keloids can develop anywhere on the skin, but are most common on the chest, the back, the shoulders, earlobes and the face around the jaw.

How are Keloids manifested?

Unlike the usual scars, keloids are located outside the area of the skin injury. Since they are created by the overgrowth of solid collagen fibers, they are hard when touched. Keloids are of an irregular shape and edges, with shiny surfaces and without hair. They are most often reddish in color due to numerous blood vessels which can be found in them. Keloids never withdraw spontaneously and have a high tendency of recurrence after a treatment. They are sensitive to touch, sometimes painful and sometimes cause an itch.

Keloids represent a significant esthetic problem, but also a health issue if they cover wrists which limits a person's movement. It is recommended that a person with a tendency for keloid development should avoid surgical procedures on parts of the skin with predilection for it.

How are keloids treated?

Keloids have an unpredictable behaviour and a tendency to reappear after the treatment. This is why the treatment of keloids is a significant medical and esthetical challenge. There are numerous therapy modalities of treatment whose choice depends on the size of the change and the effect of the previous therapies. Locally applied corticosteroids, scar creams, silicon leafs and gels, cryotherapy, are not very effective. Methods that produce satisfying results are intralesional injection of corticosteroids, laser treatment with a VBeam laser and surgical removal of keloids. All three methods are used in our clinic.

You can read more about keloid removal here…

Spec. Dr. Sladjana Cvejic, dermatologist
Dermatological clinic DERMATIM, Belgrade, Serbia