Keloid Scar – Diagnosis and Treatment
Keloids are those raised scars that pop up after your skin gets damaged. Unlike regular scars, keloids just keep growing—sometimes well past where the injury started.
They can feel very firm or even rubbery, and honestly, they tend to stand out compared to the rest of your skin. These scars don’t just disappear on their own. Some people find them itchy or uncomfortable, too.
If you get keloids after an injury, knowing what they are and how to handle them can really help.
Diagnosis
Doctors usually spot keloid scars just by looking at your skin and feeling the texture. Sometimes, they’ll order a skin biopsy to rule out skin cancer.
The main signs? Raised, thick skin, a shiny or smooth surface, and the way the scar keeps growing past the original wound. If doctors aren’t sure, they’ll run extra tests to confirm.
They may also ask about your medical history—like whether you’ve had surgery, piercings, or injuries in the area.
Keloids often show up weeks or even months after the skin heals, and they’re more common in people with darker skin tones or a family history of keloids.
Keloids can appear anywhere, but they tend to form on the chest, shoulders, earlobes, and upper back. Knowing where and how they grow helps doctors tell them apart from other skin growths.
Treatment
You’ve got a few options for treating keloid scars. Doctors might use one method or combine a few, depending on the scar’s size, where it is, and how it responds.
| Method | Common Uses | Pros | Cons |
|---|---|---|---|
| Corticosteroid Injections | Small/medium keloids | Can flatten scars | Requires several sessions, skin changes |
| Silicone Sheeting/Gel | New or existing scars | Non-invasive | Needs long-term use |
| Cryotherapy | Small keloids | Can shrink scars | Pain, skin lightening |
| Laser Therapy | Large or raised keloids | Can flatten, fade color | Skin color changes, multiple sessions |
| Surgical Removal | Resistant keloids | Removes scar tissue | High recurrence rate |
| Radiation Therapy | Post-surgery or persistent | Reduces recurrence | Long-term skin risks |
Wound Management and Pressure Therapy
For new or healing scars, wearing pressure dressings or special garments can help. These stretchy fabrics press on the healing skin.
You might need to wear them for 12 to 24 hours a day, sometimes for months. They can help reduce or prevent keloids, but honestly, wearing them that long isn’t always comfortable.
Topical and Injected Medications
Doctors often prescribe corticosteroid creams to calm down itchiness. Injecting steroids directly into the keloid can flatten smaller scars.
Usually, you’ll get these injections once a month for several months. Sometimes, doctors use other injections. Just a heads up—side effects can include skin thinning or color changes.
Physical Treatments and Medical Devices
- Silicone gel sheets or silicone elastomer sheeting pressed onto the scar can help over time.
- For best results, you need to use the gel sheeting regularly and keep at it.
Freezing (Cryotherapy)
Cryotherapy uses liquid nitrogen to freeze small keloids, making them shrink over time. You might need a few sessions.
Possible side effects include pain, blisters, and lighter skin where they treat the scar.
Laser and Light Therapies
Laser treatments, like pulsed dye or fractional ablative lasers, can flatten bigger keloids and help them fade.
These treatments usually happen over several sessions, spaced out by weeks. Sometimes, doctors combine lasers with steroid injections for better results.
Risks include crusting, blisters, or skin color changes—especially if you have darker skin.
Surgical Removal
If nothing else works, doctors might suggest surgery to remove the keloid. But, honestly, scars often come back, sometimes even bigger.
Surgeons usually add pressure garments, steroid injections, or radiation to try and keep the scar from returning.
Radiation Therapy
Low-dose radiation, often used right after surgery, can help stop keloids from growing back.
It works in some cases, but possible downsides include long-term skin problems and, rarely, cancer.
Other Treatment Options
Sometimes doctors try topical imiquimod cream or pressure garments.
Some options aim to improve how the scar looks. Others focus on easing discomfort or fixing issues that affect movement or function. Doctors often combine approaches to get the best results.
| Method | Cosmetic Use | Reconstructive Use | Helps Functional Issues |
|---|---|---|---|
| Scar Revision | Yes | Yes | Sometimes |
| Pressure Therapy | Sometimes | Yes | Yes |
- Scar Revision: Cosmetic and reconstructive surgeons use scar revision to change the size or appearance of keloid scars.
- Pressure Therapy: Special bandages or garments can help flatten keloids and ease discomfort.
Starting therapy early and taking care of wounds properly can lower your chances of getting keloids.
Everyday Habits and At-Home Care
You can do a few things at home to help with keloid formation and scar healing. Keep wounds clean and covered, just like your doctor says.
That helps your skin heal well and might cut down on the risk of thick, raised scars. Over-the-counter corticosteroid or silicone gel creams can also ease itchiness and discomfort.
| Practice | Purpose |
|---|---|
| Wound care | Supports good healing response |
| Silicone gel/cream | Reduces discomfort and irritation |
| Sun protection | Helps prevent color changes in the scar |
Try not to scratch or bump the area—extra trauma can make keloids worse.
Wear clothes that don’t rub against the scar, and use sunscreen or cover up to keep the scar less noticeable.
Getting Ready for Your Scar Consultation
Getting ready for a doctor’s visit matters, especially when it comes to keloids. Having your info organized helps you and your doctor figure out the best plan.
Here are a few things you can do before your appointment:
1. Make a List of Your Symptoms
- Jot down any changes in your skin, like new bumps or raised scars.
- Note when you first noticed these changes and if they’ve gotten worse.
- Don’t forget to mention any pain, itching, or discomfort.
2. Gather Your Medical Background
Make a quick summary of your health history, including:
| Information to Include | Details |
|---|---|
| Past injuries or surgeries | List any cuts, operations, or other procedures. |
| Family history of keloids | Does anyone in your family have similar skin issues? |
| Current medicines and treatments | Write down names of any products or medications. |
3. Make a List of Questions for the Doctor
Having questions ready makes your appointment more useful. Here are a few you might ask:
- How likely am I to get more keloids?
- What can I do after injuries or surgery to prevent scars?
- Should I avoid tattoos or piercings if I have keloids?
- How can I keep a keloid from coming back after removal?
- Could any skin product make the scar worse?
- How long does it usually take to see improvement?
- What side effects should I watch out for?
- Is there any chance a keloid could become a bigger health issue?
- What habits can help lower my keloid risk?
- How often should I come in for checkups?
Bring up anything else on your mind. It helps to have your questions written down or saved on your phone, so you don’t forget.
4. Bring a Support Person
If you can, invite a friend or family member. They might catch details you miss or help remember what the doctor says.
Keloids can affect how you feel about yourself, so having someone you trust can make a big difference.
What Your Provider Will Want to Know
Doctors need some specific info to give you the best advice for your scar.
During your visit, expect questions like:
1. About Your Scars
- When did you first notice the scar or skin change?
- Has the scar grown, gotten more raised, or changed color?
- Are you dealing with pain, itching, or other symptoms?
2. Your Health and Family History
- Have you ever hurt your skin or had surgery before?
- Does anyone in your family have scars or keloids?
- Any other skin conditions run in your family?
3. Social and Emotional Impact
- Has the scar affected your confidence or daily life?
- Do you avoid certain things because of your scar?
- Have you tried any treatments or self-care so far? Did they help?
4. Your Current Care Routine
- How do you care for your skin and wounds?
- What soaps, lotions, sunscreens, or cosmetics do you use?
- Have you had any bad reactions to these products?
Doctor’s Next Steps
Your doctor will look at your scar, ask about your symptoms, and might suggest seeing a dermatologist. They could recommend tests or talk with you about possible treatments like creams, injections, or other options.
Bringing clear information and being open about your concerns will make your appointment go smoother. Taking these steps helps you get the most out of your visit.
