What are Keloids? Keloids are a type of scar tissue that forms in response to trauma that causes proliferation of local fibroblasts and an overproduction of collagen. They present as hypertrophic, often raised lesions of the affected tissue that are larger than the original wound, extending beyond the boundaries and invading surrounding tissue. Keloids occur most often on the upper chest, shoulders, upper back, head, and neck. They may develop any time, from one month to one year after the injury.

There is a genetic predisposition associated with the formation of keloids, possibly with an autosomal mode of inheritance with incomplete penetrance. They occur more often in those of Asian or African descent.

Unlike hypertrophic scars, keloids do not heal on their own but may enlarge over time. They are often associated with other symptoms of discomfort, such as pain and pruritus.


Treatment of Keloids

Those with a predisposition should be counseled on avoiding trauma and unnecessary surgery, and on postoperative care to avoid the development of keloids.

Treatment of keloids may help reduce discomfort, reduce the volume of the scar, and allow for functional and cosmetic improvement. 

  • Intralesional corticosteroids
  • Intralesional florouracil
  • Silicone gel sheets
  • Pressure therapy
  • Cryotherapy
  • Surgical excision
  • Postoperative radiation therapy
  • Laser therapy

Source: Grabowski, G., Pacana, M. J., & Chen, E. (2020). Keloid and Hypertrophic Scar Formation, Prevention, and Management. Journal of the American Academy of Orthopaedic Surgeons, 28(10), e408–e414.