Back keloids: recognition, care, and treatment choices

It can follow acne, a cut, a piercing, surgery, or another injury. Treatment can flatten, soften, or reduce symptoms, although regrowth can occur and management often needs to be tailored.

Unlike a hypertrophic scar, which remains within the injured area, a keloid extends into nearby previously uninjured skin. Its surface may be smooth and shiny, while its colour can range from pink or red to brown or darker than the surrounding skin.

The shoulders and upper back are areas where keloids can form. A clinician can usually assess the growth by examining its boundary, texture, history, and triggering injury. An unusual or uncertain lump may need further evaluation rather than assumed scar treatment.

Reduce rubbing from straps and tight clothing, avoid picking, and protect exposed scar tissue from sunlight. Do not cut, burn, freeze, or inject a raised scar yourself.

Options may include silicone-based care, steroid injections into the scar, cryotherapy, laser treatment, or surgery combined with measures intended to limit recurrence. Selection depends on size, thickness, location, symptoms, skin characteristics, prior treatments, and personal preference.

Book a dermatology assessment if a raised scar keeps enlarging, restricts movement, causes troublesome itch or pain, or affects daily life. Rapid change, spontaneous bleeding, ulceration, discharge, marked warmth, or increasing tenderness should be evaluated promptly.

A new lump without a remembered injury also warrants examination because not every firm growth on the back is a keloid.

Ask how the diagnosis was distinguished from another lump, which outcome is realistic for colour, height, and symptoms, and whether combined therapy is appropriate. Discuss recurrence, pigment changes, wound care, and precautions before future procedures on keloid-prone skin.