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Definition:
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A keloids is a growth of extra scar tissue where the skin has healed after an injury.
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Alternative Names:
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Hypertrophic scar; Keloid scar; Scar - hypertrophic
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Causes, incidence, and risk factors:
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Keloids can form after skin injuries from:
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Acne
- Burns
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Chickenpox
- Ear piercing
- Minor scratches
- Cuts from surgery or trauma
- Vaccination sites
The problem is more common in people ages 10 to 20, and in African Americans, Asians, and Hispanics. Keloids often run in families.
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Symptoms:
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A keloid may be:
- Flesh-colored, red, or pink
- Located over the site of a wound or injury
- Lumpy (nodular) or ridged
- Tender and itchy
- Irritated from friction such as rubbing on clothing
A keloid will tan darker than the skin around it if exposed to sun during the first year after it forms. The darker color may not go away.
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Signs and tests:
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Your doctor will look at your skin to see if you have a keloid. A skin biopsy may be done to rule out other types of skin growths (tumors).
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Treatment:
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Keloids often do not need treatment. If the keloid bothers you, the following things can be done to reduce the size:
- Corticosteroid injections
- Freezing (cryotherapy)
- Laser treatments
- Radiation
- Surgical removal
- Silicone gel or patches
Many of these treatments can cause a larger keloid scar to form.
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Expectations (prognosis):
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Keloids usually are not harmful to your health but they may affect how you look. In some cases, they may become smaller, flatter, and less noticeable over time.
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Calling your health care provider:
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Call your health care provider if:
- You develop keloids and want to have them removed or reduced
- You develop new symptoms
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Prevention:
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When in the sun, cover a keloid that is forming with a patch or Band-Aid, and by use a sunblock. Continue follow these steps for at least 6 months after injury or surgery for an adult, or up to 18 months for a child.
Imiquimod cream can be used to prevent keloids from forming after surgery, or returning after they are removed.
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References:
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Juckett G, Hartman-Adams H. Management of keloids and hypertrophic scars. Am Fam Physician. 2009;80(3):253-260
Romanelli R, Dini V, Miteva M, et al. Dermal Hypertrophies. In: Bolognia JL, Jorizzo JL, Schaffer JV, et al, eds.Dermatology. 3rd ed. Philadelphia, Pa: Mosby Elsevier; 2012:chap 98.
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