Keloids are thick, puckered, itchy clusters of scar tissue that grow beyond the edges of the wound or incision.
They are often red or darker in color than the surrounding skin. Keloids occur when the body continues to produce the tough, fibrous
protein known as collagen after a wound has healed.
Keloids can appear anywhere on the body, but they're most common over the breastbone, on the earlobes, and on the
shoulders. They occur more often in dark-skinned people than in those who are fair. The tendency to develop keloids lessens with age.
Keloids are often treated by injecting a steroid medication directly into the scar tissue to reduce redness, itching, and
burning. In some cases, this will also shrink the scar.
If steroid treatment is inadequate, the scar tissue can be cut out and the wound closed with one or more layers of
stitches. This is generally an outpatient procedure, performed under local anesthesia. You should be back at work in a day or two, and
the stitches will be removed in a few days. A skin graft (see the section on skin grafting) is occasionally used, although the site from
which the graft was taken may then develop a keloid.
No matter what approach is taken, keloids have a stubborn tendency to recur, sometimes even larger than before. To
discourage this, the surgeon may combine the scar removal with steroid injections, direct application of steroids during surgery, or
radiation therapy. Or you may be asked to wear a pressure garment over the area for as long as a year. Even so, the keloid may return,
requiring repeated procedures every few years.
After scar revision
With any kind or scar revision, it's very important to follow your surgeon's instructions after surgery to make
sure the wound heals properly. Although you may be up and about very quickly, your surgeon will advise you on gradually resuming your
As you heal, keep in mind that no scar can be removed completely; the degree of improvement depends on the size
and direction of your scar, the nature and quality of your skin, and how well you care for the wound after the operation. If your scar
looks worse at first, don't panic-the final results of your surgery may not be apparent for a year or more.