Keloid scars: type, causes and risk factors

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keloid scar infection

No one wants to have some type of scar but we all had one at least in our lives. We know that when our skin is, then the fibrous tissue which is known as scar tissue is forming over the wound to repair and protect the injury. There are some cases, when the scar tissue is growing excessively which is forming smooth and hard growths that are known as keloids. They can be much larger than the original wound. Keloids are most commonly on the cheeks, earlobes, shoulders and chest. You need to know that keloids can appear in every part of your body. They are not harmful to your health but they can create cosmetic concerns for the affected person. Every single person can get a keloid scar but people who have dark skin have more chances of getting it, such as people from South Indian communities, people from African – Caribbean and people from Africa. It is known fact that when your skin is broken (for example, by a piercing, acne, burn, scratch or a cut), then your body is producing a protein called collagen. This protein gathers around the damaged skin and it builds up to help the wound seal over [1,2]. The scar which is result from it usually fades over time and it becomes smoother and less noticeable. But there are some scars which do not stop growing and they are invading the healthy cells which are leading to become bigger than the original wound. They are called keloid scars and they are affecting 10 – 15% of all wounds. Usually, keloid scars are painless but there are some keloid scars which can cause:

  • Limited movement if located on a joint
  • Burning feeling
  • Itchiness
  • Tenderness
  • Pain

There are some people who feel upset or embarrassed if they think that the keloid scar is disfiguring them. Doctors do not know why keloid scars happen. Keloid scars are not cancerous or contagious. There are some cases when keloid scars can develop after minor skin damage, such as acne scars, burns and even chicken pox but in some cases they can happen spontaneously with no history of skin trauma [2]. If you had a keloid scar in your past, then you are having more chances to get another keloid scar in the future. It is known fact that no one can completely prevent these types of scars but people can avoid any deliberate cuts or breaks in the skin, such as piercings or tattoos in which are included those on earlobes. Also you should treat the acne because this will reduce the likelihood of acne scars appearing. You should avoid minor skin surgery to those areas which are more prone to keloid scarring (such as the upper arms, back and upper chest) if possible. There are some cases when people can mistake the keloid scar for a hypertrophic scar. Hypertrophic scars are also caused by the excess tension on a wound but this type of scar remains roughly with the bounds of original scar while the keloid tissues grow beyond the original edges [1,2]. The wound which is under tension have a lot of chances to become keloid scar. They can happen in all parts of your body but they have highest chances to happen in places that have high tension and which are subject to a lot of movement, such as your ear lobes or the middle of your chest.

keloid scar ear

Keloid scars causes

Doctors do not understand exactly what the cause for keloids to form is. The alternations which are happening in the cellular signals which are controlling the proliferation and inflammation can be related to this process of keloid formation but these changes are not characterized sufficiently to explain the defect that is happening in the wound healing.

Keloid scars risk factors

Every single person can get keloid scars. People who have dark skin have more chances to get keloid scars [3]. It is shown that people who have darkly pigmented skin have 15 times more chances to develop keloid scars but people from all skin types can get them. Also it is thought that keloid scars run in families. In the studies are not said which are the exact genes which are responsible for the keloid scars [4,5]. It is known fact that younger people between the ages of 10 – 30 have increased chances of developing keloid scars. Keloid scars are common in both men and women.

References:

[1] Gauglitz GG, Korting HC, Pavicic T, et al. Hypertrophic scarring and keloids: Pathomechanisms and current and emerging treatment strategies. Molecular Medicine. 2011;17(1-2):113–25.

[2] Bayat A, McGrouther DA, Ferguson MWJ. Skin scarring. BMJ. 2003;326(7380):88–92.

[3] UW Health. Keloid scar. Retrieved from uwhealth.org/health/topic/definition/keloid/aa64380.html

[4] Shih B, Bayat A. Genetics of keloid scarring. In Archives of Dermatological Research. 2010;302(5):319-39.

[5] Marneros AG, Norris JEC, Olsen BR, et al. Clinical genetics of gamilial keloids. JAMA Dermatology. 2001.

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