What should you know about keloid scars?

Keloids form when scar tissue continues to build after skin injury, surgery, piercing, acne, or sometimes a minor scratch. They can be smooth, shiny, darker or lighter than nearby skin, and may enlarge gradually. A keloid is different from a scar that stays within the wound edges. Diagnosis is usually based on appearance, but a changing or unusual lump may need examination so other conditions are not mistaken for a scar.

Treatment depends on the scar’s size, location, symptoms, skin type, and whether it has returned after earlier treatment. Options can include steroid injected into the scar, silicone-based care, pressure, laser treatment, freezing, or surgery combined with measures intended to reduce regrowth. No single approach suits every keloid, and treatment may require staged visits. Avoid piercing or unnecessary injury through a keloid-prone area, and protect healing skin from friction and sun exposure.

Arrange a dermatology review if a scar is growing beyond the original wound, becomes painful or very itchy, restricts movement, or repeatedly breaks down. Seek prompt care for bleeding, ulceration, sudden rapid change, warmth, pus, or fever. A new lump that has not followed an obvious injury should be assessed rather than assumed to be a keloid.

Ask how the diagnosis was made, which treatment fits the scar’s location, and how recurrence will be monitored. Discuss the likely skin changes after treatment, the number of visits, and what to do if the scar becomes active again.