Keloids

Keloids are nodules that develop on the surface of the skin following an injury or trauma to that area. When skin is injured, scar tissue usually forms over the wound to help protect and heal it, but an excess or overgrowth of scar tissue can trigger the growth of a keloid. Keloids can appear anywhere on the body, even beyond the injury site. They are most common on the chest, shoulders, earlobes, and cheeks.

About 10 percent of people experience keloid scarring. People under the age of 30 may be particularly at risk. People of African, Asian, or Latino descent, pregnant women, and those with a family history of keloids are more susceptible to this type of scarring.

A keloid appears as a shiny, raised area of skin in an area that has been injured. Most keloids begin to appear within a year of the original injury and can grow larger over time. Keloids can be asymptomatic or can cause issues such as itching, burning, or tenderness, or get irritated from rubbing against clothing. In rare cases, keloids can restrict movement of the skin.

Keloids can form whenever skin is damaged. Common causes of keloid scarring include:

• Acne
• Burns
• Infection from body and ear piercings
• Surgical incisions
• Chickenpox scars
• Scratches

Keloids are diagnosed through a physical exam by a dermatologist, plastic surgeon, or primary care doctor. Often no further testing is needed to diagnose a keloid. However, your provider may want to order a biopsy to rule out any other skin conditions.

There isn’t currently a cure for keloids, but there are treatments that can improve the look and feel of keloid scars. At Boston Children’s, your child’s physician will work with you to determine the best course of treatment for keloid scars. Which include:

• Injecting a corticosteroid into the keloid scar to improve its appearance
• Laser treatment (high beams of light) to help resurface the keloid and surrounding skin
• Silicon bandages or compressive treatments to limit keloid scarring if the injury is new
• Surgical removal of the keloid if it does not respond to injections or is too large for an injection

Often more than one treatment session is needed for keloid scars, and it is common for keloids to come back after treatment is completed.

Avoiding tattoos and body piercings can help prevent keloid scarring. If your child does wear a piercing, higher-quality piercings can help minimize the forming of keloids.

Also, administer proper wound care to avoid infection and chronic irritation when your child has a new injury. Once the wound has healed, massage the scar, or apply a silicon or pressure dressing for approximately six months. Your child’s primary healthcare provider can advise the best post-injury treatment to minimize the chance of your child developing keloids.