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Definition

Keloid is a scar which is usually just a cosmetic problem. They never become malignant. A keloid is a raised growth of fibrous scar tissue that forms over an area of trauma to the skin. It extends beyond the area of the original injury. A keloid is abnormal because the scar extends above and beyond the site of the original injury. Normal scars stay confined to the site of injury. Keloids are thick, smooth areas of pink scar tissue. The scar tissue is raised above the level of the surrounding skin. African Americans are more likely to develop keloids on the legs or feet than either Asians.

Causes

The cause of keloids is unknown. But most of the researchers believe that keloids are caused by due to the body's failure to turn off the healing process needed to repair skin.

Exposure to the sun during the first year of the keloid's formation will cause the keloid to tan darker than surrounding skin. This dark coloration may become permanent.

Some specific cytokines that could be involved are TGF-b, PDGF, the interferons, prostaglandins, interleukin-6, tumor necrosis factor, interleukin-2 and others.  The actual role of any cytokine in formation of keloids is not known.

Symptoms

Keloids look like exaggerated scars. They are shiny and hairless; usually they feel hard and rubbery; and new ones are often red or purple, becoming browner and sometimes paler as they age. Most people with keloids have only one or two. However some people have many, especially if they have come up after acne or chickenpox scars.

Keloids are most commonly located on the chest, upper back, and shoulders. However, they can appear almost anywhere, such as in surgical scars any place on the body and in the earlobes or other areas that have been pierced for cosmetic purposes.

Treatment

It is difficult to remove keloids completely by allopathic treatment. Surgery is not a good option because the scar formed from surgery may grow into another keloid. Though there is no any dependable allopathic treatment to cure keloids.

The best initial treatment is to inject steroid into the keloid once a month. After several injections with cortisone, the keloid usually becomes less noticeable and flattens in three to six month's time. Hypertrophic scars often respond completely, but keloids and are notoriously difficult to treat, with recurrences commonly seen.

Other treatments have included non-antibiotic moisturizing ointments. However, it should be understood that there is no clear answer for keloid and hypertrophic scar formation. Some individuals simply have the tendency to develop keloids and despite surgical laser, chemotherapy, radiation therapy, or pharmaceutical agents, the keloids can persist.

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