What Are Keloids?


When you follow over a thousand accounts on Instagram, your daily scrolling experience can’t help but be a mixed bag. One second it’s a meme minefield, two seconds later it’s food porn, a second later it’s Chrissy Teigen. But it was during my mid-morning scroll last week when I came across the rare informative Instagram story. It was by Rajni Jacques, the Creative Lead and Fashion Director at Allure, who was with her dermatologist and Derma di Colore founder, Dr. Carlos A. Charles. The story was fashioned as “Keloids 101”. The two covered what keloids are (an overgrowth of scar tissue) and how they develop on the skin (most commonly after burns and surgeries).

Jacques and Charles also pointed out that keloids affect people of color at a greater rate, meaning that someone like me was more predisposed to getting them. I'm not going to lie—I felt like a beauty novice. I quickly texted: “Mom, do you think I can get keloids? Do you know anyone in our family who has them?” Her answers: “Yes.” And also: “Your uncle and cousin Andre.”

And that was essentially all my mom had to offer about keloids, so I went back to my original source, Dr. Charles, to learn more. If you’ve got keloids, are prone to keloids, need to know more about preventing keloids, or if you’ve never even heard the word before, listen up. Below, Dr. Charles breaks down everything you need to know.

So, what are keloids?

“Keloids are essentially abnormal scars that extend past the area of the initial injury,” explains Dr. Charles. But these scars are different than say, an acne scar. Keloids are thick, raised scars that don’t go away no matter how much vitamin C you throw at them. And the “injury” that triggers them can be as innocuous as a pimple or an ingrown hair.

Do we know why they develop?

When it comes to minor injuries—cuts, nicks, and the like—your skin has an uncanny ability to heal itself. Scars are a sign of this healing process, but a keloid is a specific kind of scar that didn’t get the message that it’s time to stop growing. So the raised skin you see is really extra scar tissue your body doesn't know what to do with. “However,” Dr. Charles notes, “the exact cause of keloids is not completely understood.” They tend to occur in areas of the body with thicker skin, such as the chest and back. Because they can run in families and affect people with darker skin tones more often, genetics certainly play a role. But Dr. Charles emphasizes that “they can occur in people of all shades of skin pigmentation."

Can they be prevented?

The golden question! “For those who are predisposed to them,” says Dr. Charles, “the best way to prevent keloids is to limit injury to the skin.” So aside from living your life as the Michelin Man—padded and protected and beloved the world over—there’s no stopping your skin from making a keloid after injury if you’re genetically inclined to getting them.

What are the initial symptoms?

Dr. Charles explains that keloids tend to itch at first. And also, “they start relatively flat and can become thick over time.”

Do they hurt?

Not really! However, “in rare occasions they can lead to mild discomfort,” says Dr. Charles.

What is the relationship between keloids and piercings?

“Piercings of course cause significant trauma to the skin,” starts Dr. Charles. By this point you should know where this is going… “Susceptible individuals can develop a keloid at the site of the piercing,” he continues. But where it gets weird is the timing of it all. “Sometimes keloids will develop several years after the piecing has been placed,” he says, essentially popping up randomly as a reminder of piercings past.

What are the treatments?

“Oftentimes, first-line treatment will involve injecting various medications (corticosteroids, for example) into the keloid to minimize its activity and attempt to flatten the lesion,” explains Dr. Charles. While you can opt for more aggressive action, like surgery, it’s better to exhaust the injection route first, because “keloids can come back after surgery, and they may be even larger than the initial lesion” he says. But if keloids are removed surgically, “they can also be treated with certain forms of either topical or localized radiation-based treatments to help prevent recurrence.”

How long until you see results from injection treatments?

Not that long! According to Dr. Charles, you should start noticing an improvement a few weeks after getting an injection.

Do over-the-counter treatments help?

You might have seen creams that promise to raze keloids. But when it comes to those, you’re better off leaving them at the store. “Over-the-counter treatments are typically not helpful,” Dr. Charles explains.

Anything else we should know?

Dr. Charles leaves us with this: “If you feel that you are developing a keloid, it’s best to see a board certified dermatologist at the first sign. If keloids are treated early they can usually be significantly improved.”

—Chloe Hall

Photo via ITG