Keloid scars
Effective treatments to fade your scars.
Keloids are persistent scars that won’t fade with time. Using an effective treatment can reduce swelling and help them fade.
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Keloids are scars that form after abnormal wound healing, and they usually form because of an increased production of collagen and an overexpression of inflammatory molecules. Unlike normal scars that heal over time and fade, keloid scars don't. They are raised, firm and are a different colour to the skin, making them more noticeable.
Keloid scars can take months to develop and continue to grow for several years. The most commonly affected areas are the chest, shoulders, earlobes and upper back. Although they aren’t usually painful, they can be itchy, tender and irritating.
There are several types of treatment for keloid scars, including topical treatments, silicone-based products and cryotherapy. The treatment you get will depend on how big your scar is and how deep it is in your skin. Standard topical treatments work to reduce inflammation and stop the production of collagen, which flattens the keloid.
Anyone with a wound can get keloid scars, but it can depend on your ethnicity and location. It’s more common in black, Asian and darker-skinned individuals than those who have white or fairer skin. For example, the average keloid incidence in African countries is 5-10% compared to less than 1% in other countries.
Certain genetic mutations will also increase the risk of developing keloids. People with Rubinstein-Taybi syndrome (RTS), for example, have a higher chance of developing it. Some research also suggests that inherited genes increase the likelihood of developing keloids. Approximately 33%-50% of people with keloids have one blood relative with keloids.
Hypertrophic scars can easily be confused with keloid scars. Both are formed during healing and look similar (both are raised and firm). The main difference is hypertrophic scars usually remain at the site of injury and fade with time, whereas keloids expand outside the site of injury and don’t regress. This means treatment is needed to fade keloids.
How we source info.
When we present you with stats, data, opinion or a consensus, we’ll tell you where this came from. And we’ll only present data as clinically reliable if it’s come from a reputable source, such as a state or government-funded health body, a peer-reviewed medical journal, or a recognised analytics or data body. Read more in our editorial policy.
Keloid scars form after a wound. This could be an artificial wound, caused by surgery, C-sections, piercings or tattooing, or a natural wound, caused by something like acne or injury.
There are three main steps in wound healing:
Keloids develop because of increased activity in the fibroblastic phase, where certain molecules (like one called TGF) responsible for collagen production are overexpressed. This increases the production of collagen up to 20x more than the normal amount.
Other molecules can also contribute to the formation of keloids, such as MMPs and TIMPs, which also contribute to your collagen levels. The function of MMPs is reduced and the function of TIMPs is increased. This causes collagen to not break down as it should, contributing to increased levels. As a result of these changes, scars are raised, thickened and firm.
Keloids can form several months after a wound and last indefinitely without treatment. This is because of uncontrolled collagen production in the fibroblastic phase, causing the keloid to grow unless proper treatment is used.
In most cases, keloid scars don’t lead to other health problems. However, people with keloids have a higher risk of developing cancer (especially skin and pancreatic). In a study involving 17,401 patients with keloids and 69,604 in the control group, 5.13% of patients with keloid developed cancer, compared to 3.5% in the control group. This suggests the cancer risk is 49% higher in people with keloid scars. The increased risk could be due to the similar environments needed for keloid formation and tumour growth (uncontrolled production and reduced degradation of molecules).
How we source info.
When we present you with stats, data, opinion or a consensus, we’ll tell you where this came from. And we’ll only present data as clinically reliable if it’s come from a reputable source, such as a state or government-funded health body, a peer-reviewed medical journal, or a recognised analytics or data body. Read more in our editorial policy.
Treatments for keloids vary from topical products to surgery. The treatment you receive is tailored to you and will depend on the location and size of the keloid.
Topical treatments such as steroids are commonly used to treat keloids. Dermovate, a steroid, contains the active ingredient clobetasol propionate which can flatten keloids. It has anti-inflammatory properties and can alter the immune system responses to prevent healing, causing the keloid to flatten.
Silicone gels are also effective at reducing scars. The statistics show silicon gel is 86% effective at reducing texture and 68% at reducing the height of the keloids. By increasing your skin’s hydration, it regulates collagen production and reduces fibroblastic activity. This flattens and softens the keloid. It also creates a barrier, preventing any bacteria from entering, and also reduces itching and discomfort.
Cryotherapy (surgery involving freezing temperatures) is a removal method for keloids. It flattens the scar by damaging the skin tissue and making it die. But external cryotherapy can cause side effects such as hypopigmentation. This can be avoided by inserting the needle in the keloid, preventing the melanocytes (cells that cause pigment) to die. Keloids can also be removed surgically, but there’s a 45%-100% chance of recurrence due to the incision. So it’s better to use another treatment after surgery, like steroids or radiotherapy, to avoid reoccurrence.
As there is no one-size fits all approach when it comes to keloid treatment, there are a few things you have to consider before choosing a medication. Such as the size and location of your scars, as well as your medical history.
To reduce swelling in keloids, you can use Dermatix, a silicone gel ointment that regulates collagen production and reduces its levels. Alternatively, steroid-based treatments like Dermovate and Elocon dampen your immune system and reduce inflammation. Each of these treatments contains different active ingredients. This means if one doesn’t work, another might be more effective for you.
Keloids don’t always require treatment, but without it, the scars won't fade. This can be irritating, painful and emotionally distressing, especially if it’s in a prominent area. Leaving keloids untreated will make them grow bigger and more noticeable. It’s better to treat them early on to prevent this.
How we source info.
When we present you with stats, data, opinion or a consensus, we’ll tell you where this came from. And we’ll only present data as clinically reliable if it’s come from a reputable source, such as a state or government-funded health body, a peer-reviewed medical journal, or a recognised analytics or data body. Read more in our editorial policy.
Have something specific you want to know? Search our info below, or ask our experts a question if you can’t find what you’re looking for.
Hypertrophic scars and keloids: a review and current treatment modalities. Biomedical Dermatology, 4(1).
Keloids: Current and emerging therapies. Scars, Burns & Healing, 6, p.205951312094049.
The Epidemiology of Keloids. Textbook on Scar Management, [online] pp.29–35.
Hypertrophic Scarring Keloids. [online] PubMed.
Keloids: A Review of Etiology, Prevention, and Treatment. The Journal of Clinical and Aesthetic Dermatology, 13(2), 33-43.
Risk of cancer development in patients with keloids. Scientific Reports, [online] 11(1), p.9390.
Understanding Keloid Pathobiology From a Quasi-Neoplastic Perspective: Less of a Scar and More of a Chronic Inflammatory Disease With Cancer-Like Tendencies. Frontiers in Immunology, 10.
The efficacy of silicone gel for the treatment of hypertrophic scars and keloids. Journal of Cutaneous and Aesthetic Surgery, 2(2), p.104.
Pressure garment therapy for preventing hypertrophic and keloid scarring after a major burn injury. Cochrane Database of Systematic Reviews.
Keloids – British Skin Foundation. [online]
Acne Scars: Pathogenesis, Classification and Treatment. Dermatology Research and Practice, 2010, pp.1–13.
Acne keloidalis nuchae: prevalence, impact, and management challenges. Clinical, Cosmetic and Investigational Dermatology, Volume 9, pp.483–489.
Potent topical steroids that can improve inflammation and itching. Generic version of Elocon.
Effectively reduces inflammation and itching. Branded version of Mometasone.
A strong topical steroid that lessens itching and improves the appearance of your scars.
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