What to know about keloid scars in skin of colour

A keloid is an overgrowth of scar tissue after an injury, piercing, injection, burn or surgery. Unlike a typical scar, it may extend past the wound edges and continue enlarging. It can be firm, smooth, shiny, darker than nearby skin, or occasionally lighter. Skin of colour may show stronger contrast when a keloid becomes darker or when inflammation leaves extra pigment. Keloids are not contagious and are not cancer, but they can affect comfort, movement or confidence.

Arrange a dermatology assessment before trying to remove or flatten the scar yourself. Treatment may involve silicone, steroid injections, pressure, freezing, laser-based care or surgery, often in combination; the choice depends on its size, site, symptoms and previous behaviour. Procedures can alter pigment or trigger more scar growth, so ask how the plan will protect surrounding skin. Avoid picking, cutting, tattooing over, or repeatedly irritating the area. Tell the clinician if you or close relatives have formed keloids before any planned procedure.

Book an assessment if a scar is enlarging beyond the original injury, becoming painful or itchy, restricting movement, or catching on clothing. Seek prompt medical review for bleeding, ulceration, sudden marked change, warmth with spreading redness, pus or fever. Those changes can signal irritation or infection and should not be explained away as ordinary scar behaviour.

Ask whether the raised area is a keloid or another type of scar, which treatment is suitable for your skin tone, how pigment changes will be managed, how many visits may be needed, and how recurrence will be monitored.