Scar on human skin, keloid on shoulder

Keloid is a type of scarring condition that occurs when an overgrowth of scar tissue forms around the site of an injury or wound. This can be caused by trauma, surgery, burns and skin conditions such as acne and chickenpox. In most cases, the raised scars are painless and harmless but may cause discomfort in some cases due to their size and location on the body. They also tend to be large and itchy, as well as discolored compared to surrounding healthy skin. 

Treatment options vary depending on the severity of the keloids but typically involve steroid injections or surgical cutting to remove them.

History and Definition

Keloids are raised, thickened scars that occur as a result of an overproduction of collagen during the healing process of a wound or injury. The exact cause of keloids is not yet understood, but genetics and skin trauma are believed to play a role.

The condition has been documented for thousands of years, with the first recorded descriptions appearing in ancient Egyptian medical texts. Medical researchers first made the distinction between keloids and hypertrophic scars in the 20th century. 

Keloids are different from hypertrophic scars in that they grow beyond the boundaries of the original wound and can become itchy, painful, and interfere with movement. Treatment options for keloids include surgical removal, corticosteroid injections, and silicone sheets or gels.


Keloids are characterized by the following symptoms:

  • Raised, thickened scars: Keloids are raised above the surrounding skin and have a bumpy texture. They can feel firm to the touch.


  • Irregular shape: Keloids are often larger than the original wound and have an irregular shape.


  • Discoloration: Keloids can be lighter or darker than the surrounding skin.


  • Itching: Some people with keloids experience itching or a burning sensation in the affected area.


  • Pain: Keloids can be painful, especially if they are located over a joint or in an area that experiences frequent friction or pressure.


  • Restriction of movement: Keloids located over joints can limit movement and cause discomfort or pain.

If you suspect you have a keloid, it is important to see a doctor for a proper diagnosis and treatment plan.


The exact cause of keloids is not fully understood, but the following factors are thought to play a role:

  • Genetics: Keloids tend to run in families, suggesting a genetic component.


  • Skin trauma: Any type of skin injury, such as cuts, burns, piercings, or acne scars, can trigger keloid formation.


  • Inflammation: Keloids are more likely to occur when the skin is inflamed, such as in cases of severe acne or after a surgical procedure.


  • Ethnic background: Keloids are more common in people with dark skin, including African Americans, Hispanics, and Asians.


  • Hormonal changes: Some research suggests that hormonal changes, such as those that occur during pregnancy, may increase the risk of keloid formation.

It is important to note that not everyone who experiences skin trauma will develop a keloid, and not all keloids are caused by skin trauma. Further research is needed to fully understand the underlying causes of keloids.


The diagnosis of keloids is typically made through a physical examination of the affected area by a doctor, a plastic surgeon, or a dermatologist. During the exam, the doctor will assess the size, shape, and texture of the scar and may use a dermatoscope to examine it more closely. In some cases, a skin biopsy may be performed to confirm the diagnosis or rule out other conditions with similar symptoms.

In addition to the physical examination, the doctor may ask questions about your medical history, including any history of skin injuries or keloids in your family. The doctor may also ask about any symptoms you are experiencing, such as itching, pain, or restriction of movement.

It is important to seek a proper diagnosis from a doctor if you suspect you have a keloid, as the symptoms of keloids can be similar to those of other skin conditions. A proper diagnosis will ensure that you receive the most appropriate and effective treatment for your case.


Treatment for keloids may include:


  • Corticosteroid injections: Corticosteroids are anti-inflammatory medications that can help reduce the size and redness of keloids.


  • Silicone sheets or gels: Silicone has been found to be effective in reducing the symptoms of keloids, such as itching and tenderness.


  • Pressure dressings: Pressure dressings can help prevent keloids from growing larger and reduce their symptoms.


  • Cryotherapy: This treatment involves freezing the keloid with liquid nitrogen, which can help reduce its size.


  • Laser therapy: Laser therapy can help reduce the appearance of keloids by shrinking them and lightening their color.


Surgical removal of a keloid is usually done as a last resort and only if other treatments have failed. A biopsy is typically performed to confirm the diagnosis of a keloid. During a biopsy, a small sample of tissue is removed and examined under a microscope to determine whether it is a keloid.

Surgery to remove a keloid is usually done under local anesthesia and may involve cutting out the keloid and stitching the skin back together. The procedure for removing a keloid involves making a small incision in the skin to remove the keloid and then stitching the skin back together.

After surgery, the incision site will be covered with a bandage and you may need to wear a pressure dressing for several days to help prevent the keloid from growing back. You may also need to attend follow-up appointments with your doctor to monitor the incision site and ensure that it is healing properly. Pain and itching are common after surgery, but these symptoms should resolve within a few days.

Risk Factors

Several risk factors can increase a person’s likelihood of developing keloids, including:

  • Family history: A family history of keloids increases the likelihood that an individual will develop keloids.


  • Dark skin: People with dark skin are more likely to develop keloids than people with lighter skin.


  • Age: Keloids can occur at any age, but they are most common in people between the ages of 10 and 30.


  • Previous injury or surgery: A previous injury or surgery in an area can increase the risk of developing a keloid in that same area.


  • Skin type: Some people have a greater tendency to develop keloids due to the thickness and texture of their skin.


  • Pregnancy: Pregnant women are at an increased risk of developing keloids due to hormonal changes and an increased amount of collagen production.


  • Location: Keloids are more likely to develop on the chest, shoulders, and earlobes.

It’s important to keep in mind that having one or more of these risk factors does not necessarily mean that a person will develop keloids. Conversely, some people who do not have any of these risk factors may still develop keloids.


Complications of keloid formation include:

  • difficulty in movement due to pain or discomfort 
  • potential infection caused by inflammation 
  • and an increased risk for further scarring if not treated promptly

In some cases, keloids can even interfere with daily activities such as wearing certain types of clothing or engaging in physical activities. The psychological effects of living with a keloid can also be significant; many people feel self-conscious about their appearance and experience feelings of embarrassment or shame related to their scars.

When to See a Doctor

If you find that a keloid is causing you discomfort, such as itching or pain, it’s important to get medical advice from your doctor. In addition, if the keloid is growing rapidly or becoming increasingly visible, it’s best to get professional help to identify the most appropriate treatment plan. Also, if you have any concerns about the size and appearance of your keloid, consulting a doctor for further assessment would be beneficial. 

Your doctor may recommend a biopsy to confirm your diagnosis. With early intervention and proper care, a keloid can be managed effectively without long-term consequences. Therefore, seeking medical assistance at an early stage is recommended for optimal results. 

Step-by-Step Guide to Carpal Tunnel Syndrome Treatment

Here’s a step-by-step guide to keloid treatment:


Schedule an appointment with a dermatologist or plastic surgeon who specializes in keloids. During the consultation, the doctor will examine the keloid and ask about your medical history.

Medical Evaluation

The doctor may order a skin biopsy to determine the type of tissue in the keloid and rule out any other skin conditions.

Treatment Options

The doctor will discuss the best treatment options for you based on the size, location, and severity of the keloid. Options include:

  • Corticosteroid injections: These are injections directly into the keloid to reduce inflammation and shrink the keloid.
  • Silicone sheets or gels: These can be applied to the keloid to help flatten it.
  • Pressure therapy: This involves wearing a pressure dressing over the keloid to reduce blood flow and encourage flattening.
  • Cryotherapy: This involves freezing the keloid with liquid nitrogen to destroy the tissue and encourage healing.

  • Surgery: This involves removing the keloid and may be recommended for larger or resistant keloids.


If you choose surgery, your doctor will give you instructions on how to prepare, including stopping certain medications, avoiding alcohol and smoking, and following a specific diet.

The surgery is typically done under local anesthesia and takes between 30 minutes to 2 hours, depending on the size of the keloid.

After surgery, you will need to follow the doctor’s instructions for aftercare, which may include using a pressure dressing, taking medications to reduce pain and swelling, and avoiding sun exposure.


Your doctor will schedule follow-up appointments to monitor the progress of your keloid and make any necessary adjustments to your treatment plan.

It’s important to remember that keloids can be difficult to treat and may require multiple treatments and a combination of approaches to achieve the best results.


In conclusion, Keloid is an abnormal and excessive growth of scar tissue which can cause discomfort and psychological distress. While there is still much to learn about the causes and treatment of this condition, a combination of surgery, pressure therapy, radiation therapy and steroid injections have been used successfully in many cases to reduce the size or eliminate keloids altogether. 

It is important to seek medical advice as soon as possible if you suspect you may have developed a keloid. Early intervention has been shown to be more successful in reducing the severity of the condition. Ultimately, understanding your risk factors for developing keloids will help you make informed decisions about how to best manage this potentially debilitating skin disorder.


If you are looking for top plastic surgery expertise and affordable costs, then Dr. Colin Hong is the perfect choice for you! With over 35 years of experience, Dr. Hong is one of the most sought-after surgeons in Toronto, North York and Markham.

Take the first step towards your new look by scheduling a consultation with our office today! Give us a call at (416) 222-6986 or send an email to with your full name, phone number and email address so we can get back to you quickly. Please also make sure that you have obtained a referral from your family doctor before contacting us about keloid treatment.  

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