What’s a Keloid?

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Keloids are raised scars made up of collagen, elastin, fibronectin, and proteoglycans that can expand beyond the original wound area. They can cause pain and itching and may impair movement. They can form from any skin injury and are more common in people with high skin pigmentation. Prevention is the best course of action, and treatment options include topical applications, compression therapy, and more invasive options such as cryosurgery and injections of steroids or chemotherapy drugs.

A keloid is a scar made up primarily of type I and type III collagen, along with elastin, fibronectin, and proteoglycans. The scar looks like a raised area at the site of a previous wound. They are benign tumors that can expand far beyond the original wound area. They are solid and gummy or glossy in appearance and range from pink to red to dark brown. The scars are often accompanied by sharp pain and itching and, in some cases, can impair movement, especially if located on a joint.

A keloid can form from any type of skin injury or abrasion, including cosmetic piercings, surgery, insect bites, burns, acne, and razor burn. More rarely, it can form spontaneously. These cancers are fifteen times more likely in people with very high skin pigmentation, and those of African ancestry may have a higher risk of developing keloids, regardless of skin color. People can develop a keloid at any age, although it’s less likely in children under 11.

There is no foolproof cure for scars. In extreme cases, such as when the tumor becomes infected and turns into an ulcer, surgery may be done, but there is at least a 50% chance of recurrence in surgically removed keloids, and the recurring scar can be even larger of the original one. The sooner treatment to shrink or eliminate tumors is started, the better the prognosis. Whenever possible, prevention is the best course of action against keloids. A person with a history of them should avoid cosmetic piercings or other body modifications, including nonessential surgery, and should pay special attention to wound healing.

They can be treated with a variety of topical applications, including aspirin paste, tea tree oil, silicone gel dressings, and natural mucin. Compression therapy, in which bandages are worn tightly over the scar, can reduce the appearance of keloids. More invasive treatment options include cryosurgery, laser or radiation therapy, and injections of steroids, interferon, or the chemotherapy drug fluorouracil.




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