When your wound starts to heal the body produces more collagen which gathers around the damaged tissue and seals it. However, in keloid scars the collagen production doesn’t stop and the scar extends beyond the borders of the original wound in the form of dense fibrous tissue.

Keloid scars are raised and range in consistency from soft and doughy to hard and rubbery. They can appear anywhere on the body although they usually form in the area of shoulders, cheeks, earlobes and neck area. Burn scars or infected lesions, including acne, are more likely to form keloids. Keloid scars sometimes itch and may be painful. Keloid scars are 15 times more likely to occur in darker-skinned individuals, may be familial, and tend to develop more readily during and after puberty.

While keloid scars are difficult to treat, combination treatments seem to be the most effective. International Clinical Recommendations on Scar Management highlight a primary role for silicone and intralesional corticosteroids in the management of a wide variety of abnormal scars including keloids. Silicone is also recommended as first-line prophylaxis for keloid scars. Other options include surgery (high risk of recurrence), radiotherapy, cryotherapy, and laser.

If your skin is keloid prone, you should avoid piercings, tattoo and any unnecessary incisions, such as plastic surgery. You should treat acne thoroughly to reduce lesions and potential for scarring or, if surgery is necessary, silicone may be combined with intralesional steroids or other treatments (above) to reduce the likelihood or size of keloid scarring.

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