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.