When a wounds heals, there is a tendency to leave a flat scar. Sometimes, during the healing process, due to mechanisms not yet fully understood, the scar tissue overgrows and thickens.

When this thickened scar tissue is confined within the margins of the wound, it is termed a hypertrophic scar.

A keloid occurs when the thicken scar tissue overgrows the margin of the original wound. It tends to occur after trauma or surgery, but can also occur after the most minor of inflammation such as acne or a simple ear piercing.

The scar tissue of a hypertrophic scar remains within the margins of the wound, and tends to stabilize over time or subside.

On the other hand, the scar tissue of a keloid overgrows the margins of the original wound, and can progressively enlarge over time without treatment.

The high-risk areas are the chestbone, upper back, deltoid region of the upper arm (where injections are commonly given) and earlobes.

The exact mechanism of the development of keloids is not fully understood.

No one knows exactly why most people never get keloids, while others get them with the mildest of inflammation such as acne (even when not irritated).There are certain factors however, that are known to increase the risk of a person developing keloids.

These include:

  1. Wounds that come under too much tension, or get infected during the healing process.
  2. Darker skin type patients tend to be at a higher risk of developing keloids than lighter skin type patients.
  3. Personal history of keloids
  4. Family history of keloids.

For some, other than the cosmetic appearance of keloids, they may not pose any physical symptoms.

However, there are patients who may experience symptoms such as itch and tenderness over their keloids.

There are several methods available for the treatment of keloids, and this depends generally on their site(s), severity and characteristics.

Non-surgical methods include treatment options such as application of topical creams and/or injections at regular intervals (eg. monthly) till maximum benefits are obtained. This is safe as very little enters the bloodstream.

Patients can usually see good results in the flattening of keloids if compliant to treatment schedule.

Combination treatments with lasers such as V-beam and CO2 laser can also be performed to further improve the aesthetic outcome of the keloids, especially in their redness.

Surgery is also a possible treatment option for certain keloids (eg. ear keloids).

The main issue with surgery on keloids is that it often runs the risk of recurrence, or the formation of an even bigger keloid later in the same place.

As such, when considering treatment options, Dr. Eileen will discuss them thoroughly with you during consultation.

Prevention is always better than cure. If someone posseses any of the above risk factors mentioned, it’s best to:

  1. Avoid body piercing and tattooing especially if they are in the high-risk zones of the body.
  2. Avoid elective skin surgery for cosmetic purposes
  3. As acne can be a cause of keloids, treat acne early to prevent deeper inflammation and permanent scarring.