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Keloid FAQs

What should I know about skin keloid treatments?

What is a skin keloid? Is it a scar?

How do keloid scars form? What is the difference between a keloid scar and a hypertrophic scar?

What are the symptoms of a keloid scar? How do I know if I have a keloid scar?

Where can a keloid scar appear?

Is ear piercing a common cause of keloid scars?

What are the other most common causes of keloid scars? Can acne cause keloids?

Are keloid scars hereditary?

What should I know about skin keloid treatments?

Skin keloids, otherwise known as keloid scars, can be a source of discomfort, pain, and in some cases self-consciousness due to physical deformity, however keloids are most definitely a source of frustration. Why? Approximately 80% of keloid scars tend to reoccur after some form of skin keloid treatment. Information on keloid scars, what they are, what they are not, how they form and why, as well as the numerous keloid treatment options out there can be very confusing and sometimes intimidating to you, the patient. All skin keloid treatment options are not created equal and therefore do not produce the same result. Dr. Slupchynskyj believes it is crucial to arm yourself with the facts and find a surgeon who has extensive experience in successfully treating all types of keloids, whether they may be caused by an ear piercing, tattoo, acne, skin injury or even if the cause is unknown.

What is a skin keloid? Is it a scar?

A skin keloid, otherwise known as a keloid scar, is excessive scar tissue that literally does not know when to stop growing. Medically speaking, keloids are fibrotic benign tumors. Keloid scars appear as tough, shiny or rubbery nodules that are raised above the skin surface, usually at the site of an injury, and sometimes from something as simple as a scratch. Keloids can, however, arise spontaneously and it is not yet known why. Skin keloids can vary in color from pink to red to brown and upon tanning, keloids tend to become darker than the rest of the skin and remain highly pigmented. Skin keloids are irregularly shaped and unlike other scars, they do not diminish over time. Some keloids can actually flatten and become less noticeable but some keloids can continue to grow indefinitely. Keloids form on any part of the body. Keloids may be accompanied by sharp pain, severe itchiness, tenderness and increased sensitivity, depending upon the patient. Besides cosmetic and physical disfigurement, keloids cause discomfort and may lead to limited mobility when located over a joint.

Skin keloids occur in about 10% of the population. Keloids are not gender specific although Dr. Slupchynskyj does see more female patients with ear keloids, possibly due to an increase in ear piercing with female patients. Persons of African descent are at increased risk experiencing a 15 times higher frequency of occurrence. Keloids are sometimes mistaken for hypertrophic scars.

How do keloid scars form? What is the difference between a keloid scar and a hypertrophic scar?

After skin has been injured, the healing process will usually leave a flat scar, level with the skin surface. Sometimes the scar is thickened, otherwise known as "hypertrophic", but the scar is confined to the margins of the trauma area. Unlike keloids, hypertrophic scars often subside by themselves (a process which can take one year or more). Treatment such as injections of cortisone can accelerate this process.

By contrast, keloids do not remain a flat scar. A skin keloid forms as the healing injured skin produces excess collagen and connective tissue extending beyond the originally damaged area. Keloids do not flatten or regress like hypertrophic scars, and may grow too unsightly, disfiguring proportions. Unlike hypertrophic scars, the time of onset is variable with a keloid and may be weeks to months after an infection or trauma. Keloids may occur spontaneously and hypertrophic scars do not.

What are the symptoms of a keloid scar? How do I know if I have a keloid scar?

  • Skin keloids are raised pink, red or brown nodules that develop at the site of injury or trauma.
  • Skin keloids tend to become darker than the rest of the skin upon tanning and remain highly pigmented thereafter.
  • Skin keloid scar tissue is not flat, and is raised above the surface of the skin.
  • Skin keloids are irregularly shaped.
  • Skin keloids grow beyond the boundaries or margins of the original wound area.
  • Skin keloids may be itchy, tender to the touch, or painful.
  • Skin keloids may ulcerate if they get infected.
  • Skin keloid scars do not diminish or regress over time as other scars do.
  • Skin keloids continue to grow if untreated.

It is imperative that keloid diagnosis be made by a physician and ideally a surgeon, who can best treat the keloid. Obtaining a skin biopsy may be necessary to confirm the diagnosis and reject the possibility of other skin growths, such as tumors.

During your consultation, Dr. Slupchynskyj will closely examine the scar(s) and surrounding skin, and thoroughly describe all skin keloid treatment options and the best specific treatment for you. A thorough medical evaluation will be completed and any risks of keloid treatment, which may cause a keloid to reoccur or otherwise, will be discussed.

Where can a keloid scar appear?

Keloids can form on any part of the body where an abrasion of some sort has occurred. Where skin keloids are mostly found? Common locations for a keloid are on earlobes, upper back, chest, and shoulders. Although their cause is unknown, keloids tend to form mainly in parts of the body where melanocyte concentration is highest, thus sparing the palms and soles.

Is ear piercing a common cause of keloid scars?

Ear piercing is one of the most common causes of skin keloids. Piercing causes trauma to the skin and scarring will then occur. Keloids can also develop following minor injuries that occur with body piercing. Since the medical world does not understand the exact reasons why some people are more prone to develop keloids, it is impossible to predict whether piercing will lead to keloid formation for one person and not another. One person might, for instance, develop a keloid in one earlobe after piercing and not in the other. Someone who has formed one keloid already should avoid any piercing, especially in body areas prone to scarring.

What are the other most common causes of keloid scars? Can acne cause keloids?

Skin keloids occur at any place on the skin during the healing of a wound or trauma. Keloids typically arise at the sites of ear or body piercing, vaccination, surgical incision, acne, burn, chickenpox scarring or even a scratch. Keloids may also form at the sites of constant skin friction or tension, (i.e. a too tight bra strap). In addition, wounds subjected to prolonged inflammation and repeated trauma are at risk for developing abnormal scars such as keloids. It crucial to ensure infection does not take place after ear piercing or wound of any type, if you are prone to keloids and even if you are not. The same can be said for acne. Skin keloids may arise in someone who is prone to keloids with prolonged and untreated acne. Skin can be damaged due to acne breakouts, which may create acne scars, which then may lead to acne keloid scars in the patient prone to developing keloid scars. It is imperative that the acne not be aggravated further by touching, picking or scratching of any kind.

Are keloid scars hereditary?

Skin keloids occur in about 5-15% of the population. Men and women are equally affected. Although people with darker skin are more likely to develop them, keloids can occur in men and women of all skin types. The average age at onset for keloid growth is 11-30 years with children under 11 years and adults over 65 years being less likely to develop keloids. African, Hispanic and Asian populations have higher frequency of keloid occurrences possibly due to the higher melanocyte concentration in the skin. Overall, those with darker pigmented skin are 15 times more susceptible to form keloid scars. There also has been shown some degree of genetic predisposition in keloid scar formation; thus, tendency for keloid development can be passed down from generation to generation.

Keloid Treatment 
Before and After Pictures of Keloid Removals Performed by Dr. Slupchynskyj 
Keloid Regression to Fibrosarcoma

 
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