Published on:

Why does keloid scars form and how to minimize them (Part I)

After a burn injury, the body tries to repair and heal the damaged skin by forming new tissue as part of the natural healing process. Collagen which is an important structural protein plays an important role in the healing process (Di Lullo et al, 2002). Collagen accumulates around the damaged area and builds up to help the wound seal the area. Usually there is a balance between the production and the breakdown of collagen.

The healing process can cause a scar to appear which usually fades away over time by becoming smoother and less noticeable. When the scar continue to grow and invade the healthy surrounding skin, it will form what is called a keloid. Keloid scars are bigger than the original wound that was created by the burn injury. They are usually higher than the normal surrounding skin, hairless and shiny, and can feel rubbery to touch.

Keloids can affect anyone but, certain people are more predisposed to form keloids more than others such as African, African-Caribbean and south Indian communities (Dark skin people tend to get keloids easier than fair skin people). More than 50 percent of patients with keloid scarring have a positive family history of keloids (Bayat et al 2005). The bigger and the deeper the burn is (reaching the dermis), the more are the chances of forming a keloid scar. It is hard to tell how much the patient will scar after a burn injury; most second and third degree burns will cause some degree of scaring.

Certain areas of the body tend to form keloids more than others when exposed to burns or trauma such as the earlobes, the sternum area, the upper back, the back of the neck and the upper arms. People usually develop keloids between the ages of 10 and 30 years but it can happen at any age. Keloids are not contagious (not transmittable by direct or indirect contact), usually not painful and are benign (non-cancerous). Very rarely, keloids may become cancerous.

Keloids can happen even after a minor trauma like an insect bite. They can develop early as the wound is healing or may take them months or even years to form. If a patient had a keloid before than he/she is at an increased risk of developing a keloid in the future. Keloid may cause disfigurement or psychological distress in some patients depending on the site, size and appearance of the scar. Keloids may limit the range of motion or cause contractures if they are located on or near a joint.

Keloid treatment can be difficult and the response to treatment is not always successful and some patients may need more than one treatment type. Despite the presence of several treatment options, there is no option which is completely effective and there is no way of preventing keloids from happening but, there are some measures that can be done to minimize the effect of the scar.

This information is not intended nor implied to be a substitute for professional medical advice; it should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Call 911 for all medical emergencies.