Keloid

Revising Medical Author: Alan Rockoff, MD
Revising Medical Editor: Melissa Stöppler, MD

• What is a keloid?
• What is the difference between a keloid and a hypertrophic scar?
• What are the signs and symptoms of keloids?
• What is the cause of keloids?
• Which people are most susceptible to keloids?
• In which area of the body are keloids most likely to appear?
• Keloids and piercing
• Is keloid prevention possible?
• Is keloid removal necessary? What are the treatments for keloids?

What is a keloid?

Keloids can be considered to be "scars that don't know when to stop." A keloid, sometimes referred to as a keloid scar, is a tough heaped-up scar that rises quite abruptly above the rest of the skin. It is irregularly shaped and tends to enlarge progressively. Unlike scars, keloids do not subside over time.

What is the difference between a keloid and a hypertrophic scar?

After the skin is injured, the healing process usually leaves a flat scar. Sometimes the scar is hypertrophic, or thickened, but confined to the margin of the wound. Hypertrophic scars often subside by themselves (a process which can take one year or more). Treatment such as injections of cortisone (steroids) can speed this process.

Keloids, by contrast, may start some time after the injury and extend beyond the wound site. This tendency to migrate into surrounding areas that weren't injured to begin with distinguishes keloids from hypertrophic scars. Keloids typically appear following surgery or injury, but they can also appear spontaneously or as a result of some slight inflammation, such as an acne pimple on the chest (even one that wasn't scratched). Other minor injuries that can trigger keloids are burns and piercings.

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