Keloids: Causes, Symptoms, and Treatment Options

Keloid or hypertrophic scar?

Hello Doctor, I have some questions I would like to ask you.
Thank you for your help: When I was in the sixth grade, I sustained an injury to the joint of my little finger, and there was a wound where I could see some white material inside, which I wasn't sure if it was bone.
After the wound healed, there was a raised area at the injury site.
Four years have passed, and there is no redness, swelling, pain, or itching, and it hasn't spread.
The color is similar to the surrounding skin, and it has even decreased in size a little without any treatment, but it hasn't completely disappeared.
Additionally, I also get acne on my chest, but it is normal and goes away after some time.
No one in my family has keloids.
Could this be a keloid? Also, can keloids develop due to changes in one's body after the injury? Is it possible for keloids to appear in some areas and not in others? I would really appreciate it if you could provide a detailed response!

Niming, 10~19 year old female. Ask Date: 2017/01/30

Dr. Wu Yuxin reply Dermatology

1.
It is impossible to determine without actually observing the lesion.
2.
It is a congenital condition.
3.
It is possible.

Reply Date: 2017/01/30

More Info

Keloids are a type of raised scar that occurs when the body produces too much collagen during the healing process after an injury. They can develop after surgery, cuts, or even minor skin injuries like acne or piercings. Understanding keloids involves recognizing their causes, symptoms, and treatment options.

Causes of Keloids
Keloids form due to an overproduction of collagen, which is a protein that helps heal wounds. The exact cause of keloid formation is not fully understood, but several factors may contribute:
1. Genetics: There is a hereditary component to keloids. If you have a family history of keloids, you may be more prone to developing them.

2. Skin Type: Keloids are more common in individuals with darker skin tones, although they can occur in anyone.

3. Location of Injury: Certain areas of the body, such as the chest, back, and shoulders, are more prone to keloid formation.

4. Age: Keloids are most common in individuals aged 10 to 30 years.

Symptoms of Keloids
Keloids typically present as raised, firm scars that can vary in color from pink to dark brown. They may not be painful, itchy, or tender, which aligns with your description of the scar on your finger. Keloids can grow larger than the original wound and may take months or even years to develop fully.
In your case, the scar on your finger, which has not changed color, is not painful, and has even reduced in size over time, could indeed be a keloid. However, the fact that it is not red, swollen, or itchy is a positive sign, as keloids can sometimes become inflamed.

Treatment Options
While keloids are not harmful, they can be bothersome for cosmetic reasons. Treatment options include:
1. Corticosteroid Injections: These can help flatten keloids and reduce inflammation.

2. Surgery: In some cases, keloids can be surgically removed, but there is a risk of recurrence.

3. Cryotherapy: Freezing the keloid can help reduce its size.

4. Laser Therapy: This can help flatten keloids and improve their appearance.

5. Silicone Sheets or Gels: These can be applied to the keloid to help flatten it over time.

Can Keloids Develop Later in Life?
Yes, keloids can develop at any age, and changes in your body or skin can trigger their formation. Factors such as hormonal changes, skin injuries, or even surgical procedures can lead to the development of keloids later in life.

Distribution of Keloids
Keloids can appear in various locations on the body, and it is possible to have keloids in some areas while being free of them in others. They do not spread like infections but can develop in response to new injuries.

Conclusion
Based on your description, it is possible that the raised scar on your finger is a keloid, especially since it has not shown signs of inflammation or discomfort. If you are concerned about its appearance or if it changes in any way, it would be wise to consult a dermatologist. They can provide a definitive diagnosis and discuss potential treatment options tailored to your needs. Remember, while keloids can be a cosmetic concern, they are generally harmless and do not pose a health risk.

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