Arm keloids: identification and treatment choices

It may develop after a cut, burn, injection, piercing, surgery or inflamed acne spot. Keloids can feel firm, itchy, tender or tight and may continue enlarging after the wound has closed. They are benign, but treatment can be useful when symptoms, movement or appearance are troubling.

A keloid forms when scar tissue keeps building beyond the boundary of an injury. This differs from a hypertrophic scar, which remains within the wound edges and may flatten over time. Skin tone, personal or family tendency, wound tension and the site of injury can influence scar behaviour. Diagnosis is usually based on examination, although an unusual, ulcerated or rapidly changing lump may require further evaluation.

Protect the scar from rubbing and sunlight, and avoid cutting, piercing or attempting to drain it yourself. Silicone gel or sheets may be discussed for suitable scars. Clinical options include steroid injections into the scar, freezing treatment and selected laser procedures. Surgery may remove bulky tissue, but a keloid can regrow, so clinicians often plan additional scar-control treatment around an operation. The choice depends on size, location, symptoms, skin characteristics and previous response.

Book a dermatology review if the scar is enlarging, persistently painful or itchy, limiting arm movement, repeatedly irritated by clothing or causing significant distress. Obtain prompt care if it becomes hot, increasingly red, swollen, open or starts draining, particularly when fever or feeling unwell accompanies these changes. A new lump without a clear preceding injury should also be examined rather than assumed to be a keloid.

Ask how the diagnosis differs from another raised scar or skin lump, and define your main goal: less itching, a flatter scar, easier movement or a change in colour. Discuss likely discomfort, wound care, pigment changes, recurrence and whether combined treatments suit your scar. Tell the clinician how earlier wounds healed and whether relatives develop raised scars.