When Scarring Goes Too Far: A Q&A on Keloids

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Scars can be troubling for a number of reasons. When on visible areas of the skin, they can affect our self confidence. When they become itchy, tender or grow larger than expected, scars become a medical issue that needs the assistance of our skilled dermatologists.

If your scar has healed too much, meaning the scar tissue has grown beyond the border of your initial injury, it is likely you have developed a keloid. At our practices in Birmingham and Chelsea, Ala., our doctors see keloids regularly. Often showing up weeks or months after the initial wound—a surgical incision, a cut, a vaccination, a bad case of acne or even an ear piercing—keloids affect about 10 percent of the population.

Do keloids ever grow unexpectedly, without an injury to the skin?

We do see patients who are genetically predisposed to spontaneous keloids on the chest. This is a very susceptible area for keloid formation even in patients who wouldn’t necessarily keloid anywhere else. Because the skin is so tight, we find that scarring there is very unpredictable.

Are certain ethnicities more at risk?

African Americans, East Asians, and people of Mediterranean or Middle Eastern descent are genetically more susceptible to keloid formation, but because they are hereditary, anyone can get a keloid.



Are certain ages more or less likely to keloid?

Because children have more flexible collagen in the make-up of their skin, they do not scar as easily as adults. We see keloids in adolescent girls who have had their ears pierced, but we rarely see a keloid in a person under age 10.

Will a keloid ever regress or fade away on its own?

No, they do not spontaneously go away.

What kind of questions can I expect at an appointment to discuss a keloid?

We always want to get a good family history. At other times in your life when you’ve had procedures, how did you heal? Has anyone in your family struggled with fibroid tumors or atherosclerosis (hardening of the arteries)? Because keloids are a fibroproliferative disorder, all of these conditions are interrelated. A full history will help us determine how difficult it will be to treat your keloids and how susceptible you may be to developing more keloids from minor procedures.

What does treatment look like?

We counsel patients that keloids require careful treatment, because we do not want to irritate a site already prone to over-scarring. Traditional therapies include injections, radiation and topical treatment. Skin Wellness Center of Alabama is the first practice in Birmingham to offer CryoShape™, a new cryotherapy technology to effectively minimize and soothe keloid scars. Requiring only a local anesthesia, the procedure allows us to use a probe to freeze the keloid from the inside out. More than 97 percent of patients never see their growth return.

What should I expect my scar to look like once treatment is complete?

Once your scar has flattened, we may find your skin needs additional treatment in our offices to accelerate the healing process and regain a healthy, radiant glow. With Fraxel® Dual, a safe and non-invasive fractional laser treatment, we can greatly reduce the appearance of scarring and discoloration on the skin. These treatments eliminate damaged cells so the healthy cells can be exposed.
You do not have to spend each day hiding unsightly scar tissue or suffering from the restriction, pain or itchiness associated with a keloid. Contact Skin Wellness Center of Alabama for a consultation with our experienced team today.