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keloid is an abnormal scar, a bizarre response to injury. Actually, it is an overgrowth of scar tissue. The scar tissue continues to form long after it is needed, building up extra tissue and resulting in a hard, smooth, and round lump.
Keloids – also known as hypertrophic scars – are a medical mystery. We don’t know what causes them. Nor can we predict when, where, and in whom they will occur, or how large they'll become. We do know that they are much more common in Asians and blacks, who have a tendency to develop keloids even after minor injuries.
Keloids often develop over earlobes after ear piercing; over the upper arm following vaccinations; over appendectomy and gall bladder operation scars, and over the chest area following acne bumps that have healed. They develop more commonly over the skin of the central portion of the body.
If you have a keloid, don’t be alarmed. The only problem it usually causes is cosmetic. In rare instances keloids also may be somewhat incapacitating, for example, if they develop across joints.
If the keloid is small and inconspicuous, let it be. For larger lesions and those that are cosmetically unacceptable, your dermatologist can offer a variety of treatments – but no guarantees that they will work. Keloids are highly resistant to treatment. The type of treatment your dermatologist will try will depend upon the age, size, and location of the keloids. Older and larger keloids are much more difficult to treat.
Treatment methods include injecting a cortisone-like substance directly into the keloid; removing the keloid surgically and following it up with the same cortisone injections (surgical excision alone will only make the keloid recur – and possibly even larger than the original lesion); various types of sheeting that, when applied for weeks or months, may diminish the size and extent of the keloid; and freezing the area with liquid nitrogen or dry ice. Good results for stubborn keloids have been reported using the carbon dioxide or pulsed dye laser.
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