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What Causes Keloids + How to Treat Them

By Tiffany Harrison

Sometimes, when a wound is in its healing stage, a keloid shows up. Keloids are raised fibrotic scar tissue that grows outside the perimeter of the original wound, and they are often much larger than the original wound itself. Importantly, they’re totally harmless and non-cancerous; they are a cosmetic, not health, concern. And they’re fairly common; roughly 10% of the population will have keloid scarring in their lives.

So, what causes keloids?

CAUSES

Do you have pierced ears, tattoos, surgical incisions, acne scars, or burns? These have all been linked to the development of keloids. Skin or muscle tension and recurrent trauma to scar can cause keloids to form, too. Genetics also play a key factor, and people with more melanin are much more likely to develop keloids in the first place. In fact, Black people are five to fifteen times more likely to develop keloids than white people.

TREATMENTS 

There are several treatments available for keloids, but depending on the method, they’re still likely to return. Surgical removal isn’t reliable on its own, but should be combined with another treatment. These include corticosteroid injections, long-term bandage compression, repeat cryosurgery (i.e. freezing with liquid nitrogen), radiation therapy (which is risky and can potentially increase a patient’s risk of cancer,) laser therapy, or fluorouracil injections.

PREVENTION

Because keloids are notoriously difficult to treat, combining treatments often offers a better long-term solution—but the best keloid treatment is prevention. Specifically, those who are prone to keloids should avoid cosmetic surgeries, piercings, and tattoos altogether. However, if surgical incisions are essential, patients can work with their doctors to minimize the possibility of keloid formation. This includes covering the healing incision with hypoallergenic paper tape or silicone gels, and the use of corticosteroid injections or even localized radiation treatments post-operation. 

Limiting exposure to the sun will help to prevent further darkening and discoloration to the scar. It’s important to note that keloids are more of a cosmetic concern rather than a health-related one, so it’s encouraged to just accept and embrace them as beautiful imperfections!