Keloid scars: Overview

Keloid scar on the back of a hand

Not everyone who gets a scar will develop a keloid.

In what race are keloids most common?

People of all races get keloids. Findings from studies, however, suggest that Black people have the greatest risk of developing keloids. People of Asian, Latin American, or Mediterranean descent are more likely to develop keloids than people who have a lighter skin tone.

Why are keloids more common among people who have a darker skin tone?

Researchers have found that between 33% and 50% of people who develop a keloid have at least one blood relative who gets keloids. This suggests that some people inherit genes that make them more likely to develop keloids.

Dermatologists have found that these genes are more common in people who have a darker skin tone. In the United States, Black people are most likely to have one or more blood relatives who get keloids.

When do keloids appear?

A keloid usually takes time to appear. After you injure your skin, months can pass before this scar appears. Once it begins, a keloid tends to grow slowly for months or years.

This slow growth differs greatly from the other type of raised scar called a hypertrophic scar.

If you have a hypertrophic scar, it appears one to two months after you wound your skin and the scar tissue doesn’t grow beyond the wound. With time, a hypertrophic scar often becomes less noticeable.

While keloids tend to develop slowly, some appear more quickly.

Do keloids go away?

Unlike a hypertrophic scar, a keloid doesn’t fade with time. To reduce the appearance of a keloid, you need to treat it.

When it comes to treatment, no one treatment works best for all keloids. That’s why dermatologists consider where the keloid appears on your body, its size, and how deeply the keloid penetrates your skin.

Your age and how you responded to past treatment for a keloid also help determine what type of treatment would give you best results.

Do keloids hurt?

While a keloid is growing, it can cause pain or discomfort. The pain usually goes away when the keloid stops growing.

On rare occasion, keloids can remain tender and painful.

Can a keloid turn into cancer?

No, keloids do not turn into cancer.

What do keloids look like?

The size and shape of keloids vary. On an earlobe, you’ll likely see a round, solid mass. When a keloid forms on a shoulder or the chest, the raised scar tends to spread out across the skin. It often looks like a liquid spilled on the skin and then hardened.

You’ll find pictures of keloids that show the different ways these scars can appear on the skin and symptoms they can cause at Keloid scars: Signs and symptoms.

Images
Getty Images

References
Chike-Obi CJ, Cole PD, et al. “Keloids: pathogenesis, clinical features, and management.” Semin Plast Surg. 2009;23(3):178-184. doi:10.1055/s-0029-1224797.

Daggett A, Congcharoen J, et al. “Top 10 things you need to know about keloids and their treatment.” J Miss State Med Assoc. 2016;57(4):108-11.

Gao FL, Jin R, et al. “The contribution of melanocytes to pathological scar formation during wound healing.” Int J Clin Exp Med. 2013;6(7):609-13.

High WA. “Special considerations in skin of color.” In: Fitzpatrick JE, et al. Dermatology Secrets Plus (5th edition). Elsevier. China, 2016:556.

Jfri A, Alajmi A. “Spontaneous keloids: A literature review. Dermatology. 2018;234:127-30.

Kelly AP, Bayat A. “Keloids” In: Kelly AP, Taylor SC, et al. Dermatology for Skin of Color [2nd ed]. The McGraw Hill Companies, United States of America, 2016.208-22.

McGinty S, Siddiqui WJ. “Keloid.” [Updated 2021 Jul 24]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan.

Written by:
Paula Ludmann, MS

Reviewed by:
Arturo R. Dominguez, MD, FAAD
Ivy Lee, MD, FAAD

Last updated: 8/30/22