Understanding Keloids: Causes, Symptoms, and Treatments

Understanding Keloids: Causes, Symptoms, and Treatments

Keloids are a type of benign growth that develop as a result of abnormal healing responses to skin trauma. These unsightly, raised, and reddish-purple scars are a source of embarrassment and discomfort for many people. In this article, we will delve into the science behind keloid formation, their causes, and symptoms, as well as the methods for diagnosing and treating them.

What are Keloids?

Definition and Overview

Keloids are an overgrowth of scar tissue that can form at the site of a skin injury, like a cut or burn. They are characterized by their raised and thick appearance, and they can extend beyond the boundaries of the original wound.

The Science Behind Keloid Formation

Normally, when you get a cut, your body rushes to close it and repair the damaged tissue. Fibroblasts, which are cells in the skin responsible for producing the protein collagen, create new tissue that fills in the wound. With time, the skin becomes stronger and less prone to injury. However, in some people, the healing process goes into overdrive, causing the growth of keloids.

While the exact mechanisms behind keloid formation are not fully understood, scientists believe that several factors contribute to the development of these scars. These include genetic predisposition, skin injuries, infections, and inflammation.

Genetic Predisposition

Research has shown that keloids tend to run in families, suggesting that there may be a genetic component to their formation. Studies have identified several genes that may be involved in keloid development, including those that regulate collagen production and inflammation.

Skin Injuries

Keloids are most commonly associated with skin injuries, such as cuts, burns, and surgical incisions. However, not all skin injuries lead to keloid formation, and the severity of the injury does not always correlate with the size or appearance of the keloid. Some people may be more prone to developing keloids due to the location or type of injury.


Infections at the site of a skin injury can increase the likelihood of keloid formation. This is because infections can trigger an inflammatory response, which can lead to the overproduction of collagen and the formation of scar tissue. In addition, some bacteria may produce toxins that can directly damage skin cells and promote keloid growth.


Chronic inflammation, whether from an infection or another source, can also contribute to keloid formation. Inflammation triggers the release of cytokines, which are proteins that regulate the immune response. Some cytokines, such as transforming growth factor beta (TGF-β), can stimulate fibroblasts to produce more collagen and promote the growth of scar tissue.

In conclusion, while keloid formation is not fully understood, it is clear that multiple factors contribute to their development. Genetic predisposition, skin injuries, infections, and inflammation all play a role in the formation of these raised and thick scars.

Causes of Keloids

Keloids are a type of raised scar that occurs when the body produces too much collagen at the site of an injury. They can be unsightly and uncomfortable, and can even cause itching and pain. While the exact cause of keloids is not fully understood, there are several factors that are believed to contribute to their formation.

Genetic Factors

Scientists are still trying to unravel the complexities of the genetic component that contributes to keloid formation. However, it is clear that the condition runs in families, indicating that there is a genetic basis for the condition. Researchers have identified several genes that may be involved in the development of keloids, including those that regulate collagen production and those that control the immune response. The risk of developing keloids is higher in people with a family history of the condition.

Skin Injuries and Wound Healing

Keloids often develop at the site of skin injuries, such as cuts, burns, and surgical incisions. The risk of keloid formation increases with the severity of the injury. When the skin is traumatized, fibroblasts produce more collagen than necessary, forming a raised and thickened scar that extends beyond the boundaries of the wound. People with darker skin are more prone to keloid formation in response to skin injuries than those with lighter skin.

There are several factors that can affect wound healing and increase the risk of keloid formation. These include poor nutrition, smoking, and certain medical conditions such as diabetes and autoimmune disorders. In addition, some medications, such as steroids and chemotherapy drugs, can interfere with the healing process and increase the risk of keloid formation.

Infections and Inflammation

Keloids may also occur in response to infection or inflammation, which trigger the body’s immune response and cause the release of cytokines and growth factors that promote tissue growth and healing. In some cases, the normal healing process becomes disrupted, leading to keloid formation. Infections that can lead to keloids include acne, chickenpox, and ear piercings. Inflammation from conditions such as psoriasis and eczema can also increase the risk of keloid formation.

It is important to note that not everyone who experiences an injury or infection will develop a keloid. The exact reason why some people are more prone to keloid formation than others is not fully understood, but it is believed to be a combination of genetic and environmental factors.

Symptoms and Characteristics of Keloids

Keloids are a type of scar that occurs when the body’s natural healing process produces too much collagen, resulting in an overgrowth of tissue. They can be unsightly and cause discomfort, and can occur in people of all ages and skin types.

Appearance and Texture

Keloids are raised, thick, and firm scars that usually have a reddish-purple hue. They can extend beyond the boundaries of the original wound and have a smooth and shiny surface. Keloids can be differentiated from other types of scars by their size and shape, as well as their tendency to grow beyond the site of the original injury.

While keloids can occur anywhere on the body, they are most commonly found on the chest, shoulders, back, and earlobes. They can range in size from small to large, and can continue to grow over time.

Discomfort and Pain

Keloids can be uncomfortable and itchy, sometimes causing pain or tenderness. The discomfort can be exacerbated by tight clothing or jewelry that rubs against the affected area. In some cases, keloids can also cause psychological distress, affecting a person’s self-esteem and quality of life.

It is important to note that not all raised scars are keloids. Some raised scars, such as hypertrophic scars, are similar in appearance but do not extend beyond the boundaries of the original wound.

Treatment Options

While keloids can be difficult to treat, there are several options available. Treatment may involve a combination of therapies, including:

  • Corticosteroid injections
  • Cryotherapy
  • Pressure dressings
  • Silicone gel or sheets
  • Surgical removal

Your doctor can help determine the best course of treatment based on the location, size, and severity of your keloid.

It is important to note that keloids can recur even after treatment, so it is important to follow your doctor’s instructions carefully and monitor the affected area for any changes.

Overall, while keloids can be a frustrating and uncomfortable condition, there are treatment options available to help manage and reduce their appearance.

Diagnosing Keloids

Physical Examination

A doctor can usually diagnose keloids by simply examining the scar and asking the patient about their medical history and family history of skin disorders. They will look for signs of raised, thickened, and reddish-purple scars that extend beyond the boundaries of the original wound.

Medical History

A doctor will ask about any skin injuries or infections that the patient has had in the past, as well as any family history of keloids or other skin disorders. They will also inquire about any medications that the patient is taking that may affect wound healing.

Biopsy and Lab Tests

In some cases, a doctor may perform a biopsy and send the tissue sample to a laboratory for analysis. This can help rule out other skin conditions that may resemble a keloid and provide more information about the genetic and biological factors that contribute to keloid formation.

Treatment of Keloids

There is no one-size-fits-all treatment for keloids, and the choice of treatment depends on the size, location, and severity of the scar. Some treatment options include:

  • Steroid injections: Corticosteroids can reduce inflammation and shrink the size of a keloid. They are typically injected directly into the scar and may need to be repeated several times over several months.
  • Cryotherapy: This involves freezing the keloid with liquid nitrogen, causing the scar tissue to die and fall off. This treatment can be painful and may require several sessions.
  • Surgical removal: This involves cutting out the keloid surgically and stitching the skin back together. However, this treatment can sometimes make the keloid worse if the wound does not heal properly.
  • Pressure therapy: This involves applying pressure to the keloid using a special dressing or bandage. This can help flatten the scar and reduce its size over time.
  • Laser therapy: This involves using laser light to break down the scar tissue and reduce its size. This treatment is effective for small keloids and may require several sessions.

Overall, keloids can be frustrating to live with, but there are a range of treatments that can minimize their appearance and discomfort. Working closely with a dermatologist can help you find the best treatment for your needs and help you gain back confidence and comfort in your skin.

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