A keloid can result from an overgrowth of scar tissue at the site of a healed skin injury following an ear-piercing, an infection on a wound site, repeated trauma to an area, acne scarring and it spreads beyond the original area of skin damage.
Keloids most commonly occur on the upper chest, shoulders, head and neck, though they can occur anywhere on the body. They are often familial and are more common in individuals with darker skin, which is more likely to develop in younger individuals (typically under 30).
A keloid is enlarged and raised and can be pink, red, skin-coloured or darker than the surrounding skin, may sometimes form months, or even longer, after an initial injury. When skin is injured, scar tissue forms over the wound to repair and protect the injury. Extra scar tissue grows, forming smooth, hard growths called keloids. Although a keloid tumour is benign, its appearance does not improve with time and can often cause individuals to worry about its cosmetic appearance. It can sometimes also be painful and accompanied by itchiness and redness. In some cases, this can lead to functional impairment and a reduction in quality of life.
Treatment of keloids
Unfortunately, the recurrence rate of keloids treated with surgery alone is as high as 80% but the treatment of keloids by surgical excision followed by radiotherapy has been shown to be highly effective in reducing keloid recurrence. A study published in the Plastic & Reconstructive Surgery journal in May 2003 found that a single dose of post-operative superficial radiotherapy, when given within 24hrs after surgical excision, prevented recurrence in as many as 90% of cases.
Some keloids are not amenable to resection, for example, those following sternotomy as a result of open-heart surgery.
Following radiotherapy after surgery, the skin in the area treated with radiotherapy may become dry for around two to four weeks and hydrating products can then be applied to accelerate the skin regeneration process. The skin then becomes darker and this may last for about a year before slowly disappearing without any further action.