Keloid Scars

What are keloid scars

Keloids are raised, bumpy, firm or rubbery scars that result from an abnormal healing response to skin injury. Unlike other scars, keloids outgrow the original wound boundaries. This means that an injury as small as a pinprick, such as from an insect bite, spot or ear piercing, can become a large keloid scar. No one yet knows the underlying cause of the abnormal healing that leads to keloid scars; it is an area of ongoing research.

Keloid facts

  • Keloids are composed of thick scar tissue and are the result of an over-production of collagen in the scar during healing.
  • They can continue to grow over a period of months or even years.
  • Their colour can be very different to that of surrounding skin, varying from flesh-coloured to pink, red or dark brown.
  • Keloids are more common in darker skin types.
  • Keloid scars can bleed and become infected.
  • They can affect any area of skin, but the most common areas include the shoulders, upper back and chest, neck, ears and face.
  • If someone develops a keloid scar on one part of their body, their skin may still heal normally in other body areas.
  • Keloid scars are benign and non-contagious.

How might keloid scars affect me?

People with keloid scars can suffer from a number of symptoms which can impact on their daily life and make the scars difficult to live with.

Keloid scars can cause physical symptoms of:

  • Pain
  • Itching
  • Restriction of movement

Keloid scars can have negative effects on people’s wider lives too. The following are quotes from people with keloid scars which demonstrate some of the ways they can affect their lives:

Social life:

“I feel I can't wear the clothes I like because I worry people will see my scars.”

“Now I feel self-conscious about going swimming.”

Work life:

“My scar makes me uncomfortable while writing.”

“I find manual work difficult because of my scar.”

Relationships and sex life:

“Because of my scar I don’t feel confident undressing myself in front of my husband.”

“It stops me from enjoying my sex life so much.”

Psychological wellbeing:

Sometimes I feel depressed because my scar.”

“My scar has made me more self-conscious and I am not confident with myself anymore.”

What treatments are available?

There are a number of treatments for keloid scars.These include:

Conservative management

This involves application of silicone gel or sheets, use of steroid tape or sheets, pressure garments and pressure earring.  A nurse can guide you in how best you can massage and manage your scar during the healing phase.

Intralesional Steroid Injection

Steroid is administered directly into the scar tissue every six to eight weeks. This helps flatten and soften the scar, it helps reduce discomfort such as pain and itchiness. The number of injections needed varies, larger and or older keloid scars require longer period of treatment.

Intralesional Excision (Surgery)

This surgical procedure can be done to reduce the size of larger keloid scars before commencing regular steroid treatment. The scar tissue is removed from within the keloid boundaries, without harming normal surrounding skin to avoid producing further scaring.  This can be done as a minor procedure or as a day case. Further steroid treatment is required following this procedure.

This information has been provided by Flordelyn Selim, Scar Management Clinical Nurse Specialist, Royal London Hospital.