What Causes Keloid Scars?

After skin is injured, the body builds collagen to close and strengthen the area. In a keloid, collagen production and remodelling continue beyond the wound edges, so the scar becomes raised, firm, and wider than the original mark. A keloid can follow a cut, piercing, burn, injection, or operation. Acne can also leave inflammation or broken skin that becomes a starting point for a keloid. A keloid is different from a hypertrophic scar because it extends outside the original injury rather than staying within its borders.

Avoid picking acne, scabs, or healing skin, because repeated trauma can add inflammation. Protect a healing area from friction and follow wound-care instructions after a procedure. If a scar is enlarging, itchy, tender, or affecting movement, arrange a skin assessment. Treatment may involve silicone-based care, injections, pressure, freezing, laser-based treatment, or removal; the choice depends on the scar and its location. Surgical removal can be followed by another keloid, so discuss prevention as part of the plan.

Seek medical assessment when a scar grows outside the original wound, becomes painful or persistently itchy, cracks, bleeds, or restricts movement. An enlarging mark should be examined before treatment is chosen, particularly if its appearance is changing or the diagnosis is uncertain.

Ask whether the raised area fits a keloid or another type of scar, what may have triggered it, and how recurrence can be reduced. You can also ask which treatment suits its size, age, location, symptoms, and effect on movement.