Keloid and hypertrophic scars

What are keloid scars?

Keloid scars result when scar tissue does not heal and becomes larger over time. Usually collagen is produced by the body and gathers around the damaged skin to form a scar which fades over time. However, in the case of keloid scars, the scar does not fade and actually becomes bigger than the original wound. Keloid scars are sometimes known as 'overgrown scars'. Hypertrophic scars are similar to keloid scars but they differ in that the change in the skin is limited to the scar, while a keloid scar causes changes to the skin around the scar as well.

What do keloid scars look like?

Keloid scars appear raised above the skin and are usually shiny and hairless. They are most commonly found on the ear lobes, shoulders, chest and the back, but they can develop all over the body. Some scars appear clumpy and may feel hard with a rubbery texture. In some cases new scars appear red or purple in colour, and it can take the scar many months to develop after the initial wound.

The scars are not usually painful but they can affect confidence and self-esteem, especially if they are present on areas of the skin which are visible to others. Some people suffer from embarrassment and shame as a result and this can impact how they behave around others or the way they dress.

Who is affected by keloid and hypertrophic scars?

Keloid scars can affect anyone but they tend to be more common in people with darker skin. They are most common among people of African, Caribbean and Indian heritage. It is possible for keloid scars to run in families and they are most often diagnosed in people aged between 10 and 30 years old.

Treatment for keloid scars

There are several treatment options available for patients with keloid scars, with patients normally treated by specialist dermatologists. Treatments include:

• Steroid injections.
• Applying tape which contains steroids to the scar (this is done for at least 12 hours per day).
• Surgery (this is not always successful and the scar can grow back and may be larger than the original scar).
• Applying a silicone gel sheet to the scar for a period of time.
• Freezing the scar (this may be effective in preventing the scar from growing during the early stages).
• Laser therapy (this reduces redness but will not affect the size of the scar).