Keloid scars in skin of colour: what to know

A keloid is an overgrowth of scar tissue after the skin is injured. It can follow acne, a piercing, surgery, a burn, or a small cut. The scar may be firm, smooth, itchy, sore, or larger than the original wound. In deeper skin tones, inflammation may look brown, purple, or darker rather than bright red, and the area may remain lighter or darker after irritation settles.

Skin colour does not make a raised scar automatically a keloid. A clinician considers the border, texture, timing, symptoms, and the original injury. Sharing photographs from earlier stages can clarify whether the area is changing.

Seek an assessment if a scar extends beyond the wound, becomes uncomfortable, or keeps changing. Avoid picking, unnecessary friction, and unplanned cosmetic procedures on the area. Use gentle skin care and protect healing skin from ultraviolet exposure, because inflammation can deepen colour change.

Treatment is individual. A clinician may discuss injections, silicone-based scar care, laser treatment, freezing treatment, or surgery, with attention to the possibility of pigment change after irritation. Ask how the proposed treatment may affect your natural skin tone and how healing will be monitored.

Arrange prompt review if the scar grows quickly, becomes hot or increasingly painful, opens, bleeds, or drains fluid. Seek urgent help for facial swelling that affects breathing or swallowing. A new changing lump also deserves examination rather than being labelled from a photograph.

Ask how the diagnosis was made, whether your skin tone changes the risk of dark or light marks after treatment, which options minimise irritation, and how recurrence or pigment change will be followed.