Who Is at Risk for Developing Keloid Scars?

Who Is at Risk for Developing Keloid Scars?

Unfortunately, even though many people might want reassurance that their surgery, piercing, or other skin injury will not lead to a keloid scar, there is no accurate way to predict this. A keloid scar is a scar that remains large, raised, dark, and possibly painful or itchy after the injury is healed; it also may continue to grow, resulting in a large, lumpy, puffy, or otherwise unsightly scar.

Hypertrophic scars can initially look and feel like keloids. However, the most important difference between a keloid and a hypertrophic scar is that hypertrophic scars do not grow past the original boundaries of the skin injury like keloids do.

The fact is that it is not well-understood why some people develop keloids and why some people don’t, or why the same person might form a keloid scar in one area and not in another. It is known that the cellular signals that control growth change somehow, causing the keloid formation, but it is not understood why or how these changes occur.

Keloids Sometimes Run in Families
Men and women are equally likely to develop keloids. In the past, keloids were more common in women, because women got more earlobe and body piercings. Now this is no longer the case, and keloids are found with roughly equal frequency in men and women. The tendency for keloids to form may also run in families in some instances, so if someone in your family has a keloid, you may want to rethink a piercing, tattoo, or nonessential surgery.

At What Ages Do Keloids Form?
Although a keloid scar can form at any age, they do seem to occur most often between the ages of 10 and 30, with the average keloid sufferer in his or her early 20s. Keloids are less common in children and in the elderly, but they do occur at these ages, too.

Read: Do Scars Grow With Age?

Keloids More Likely to Form in Certain Skin Types and In Certain Areas
Keloids can occur in all skin types, although people with certain skin types may also be more vulnerable. There is a higher incidence of keloids in people with darker skin types as well as extremely fair skin types. Keloids can also occur on any part of the skin, but certain areas may be more likely to see keloid formation. Areas where there are piercings are particularly susceptible, as are areas where the skin stretches or otherwise experiences tension during wound healing.

Prevention Is Key
Because keloid scarring is difficult to treat, people should make choices that minimize their risk of developing a keloid scar in the first place. People who know that they are in a high-risk group – because they have dark skin, for example, or are the right age or have had a keloid scar before – should avoid any type of piercing or elective surgery. If you do get piercings or surgery anyway, or have some other type of skin injury, then steps should be taken to ensure fast and complete healing, avoid infection, and reduce skin tension as the area heals. Be sure to eat a healthy diet, get plenty of exercise, and avoid smoking for optimal healing of any wound.

If you do find that you are developing a keloid scar, immediately becoming proactive in treating it may minimize the size and appearance of the scar. A silicone-based scar treatment will definitely help. See your dermatologist or plastic surgeon as soon as you see changes that you find concerning. If you are developing a keloid, the next step in terms of treatment options is a steroid injection into the scar. This can make the scar much softer and prevent it from getting worse. Occasionally you may need more than one steroid injection over time, but be sure to discuss the risks with your physician beforehand. If steroid injections don’t work, more invasive options are available for really severe cases. These include re-excision, often in conjunction with another steroid shot, and even radiation therapy if the keloid is exceptionally severe.

Have a question about your scar? Post a comment and we’ll be happy to answer.

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The information on this site is provided as an information resource only, and is not to be used or relied on for any diagnostic or treatment purposes. Please speak to your doctor to treat any medical condition. Information on this site is not intended to be patient education, does not create any patient-physician relationship, and should not be used as a substitute for professional diagnosis and treatment.

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