What should you know about spontaneous keloid?

Keloids form when scar tissue continues to build beyond the original area of skin damage. Sometimes the trigger was minor, such as an insect bite, acne spot, injection, or unnoticed scratch. The lump may be smooth, shiny, darker or lighter than nearby skin, and extend gradually. It can itch, feel tender, or become uncomfortable when clothing rubs it. A keloid is different from a scar that stays within the wound edges, although examination is needed to distinguish it from other skin lumps.

A dermatologist may examine its surface, firmness, colour, location, and growth pattern. If the diagnosis is uncertain, a small sample may be discussed. Do not cut, pierce, or repeatedly irritate the area because trauma can encourage more scar tissue.

Arrange a dermatology assessment if a new raised lump is enlarging, itchy, painful, or catching on jewellery or clothing. Tell the clinician about previous scars, acne, piercings, injections, and any family tendency to keloids. Treatment is chosen for the lump’s size, location, symptoms, and likelihood of returning. Options may include steroid injection into the skin, silicone-based care, laser treatment, freezing, or surgery, often with a plan to reduce regrowth after removal. Results usually require planned follow-up rather than a single visit.

Seek prompt medical review if the lump changes rapidly, bleeds, ulcerates, becomes markedly painful, or is accompanied by spreading redness, warmth, or drainage. A lump near an eye, joint, or airway deserves particular attention because its position can affect function. Emergency help is appropriate for sudden breathing difficulty or facial swelling, although those symptoms are not typical features of a keloid.

Does this growth look like a keloid or another skin lump? Could a previous minor injury explain it? Which treatment limits regrowth, and how long should follow-up continue?