Keloid is a type of scar that is frequently found in black people. In the vast majority of cases it is largely a cosmetic problem but in a few cases it can interfere with movements.

What is a Keloid?
A keloid scar is a benign (non cancerous), non contagious scar that develops at the site of injury. After a wound has occurred to the skin both skin cells and connective tissue cells begin to multiplying to repair the damage. A scar is made up of connective tissue deposited by the fibroblasts. In keloids the fibroblasts continue to multiple even after the wound is filled in. Thus keloids project above the surface of the skin and form large mounds of scar tissue.

Keloids can be accompanied by severe itchiness, sharp pains.

Keloids can occur after minor injuries, even after a scratch or pimple.

Who gets Keloids?
It is estimated that keloids occur in about 10% of people.

Keloids occur in both men and women. They occur in all racial groups but tend to be more common in blacks than other races.

What sites do keloids occur?
Keloids can occur in any part of the body, although the upper chest, shoulders and back are especially prone to keloid formation. The ears are a common site manly in females who had their ears pierced. Due to piercing for rings at various sites in the body, one expects to see more keloids at other sites.

Can keloids be prevented?
Many individuals are prone for keloid formation and often they cannot be prevented. In some individuals various techniques have been used to prevent keloids.

Some keloids can be prevented by using a pressure dressing, silicone gel pad or paper tape over the injury site. These are left on for 23 of 24 hours each day. This treatment is after healing of the wound or injury, usually within a month. Once keloids are formed there is no completely treatment for keloids.

What is the treatment for keloids?
Treatments for keloids include the following:
• Cryosurgery (freezing)
• Excision
• Laser
• X-rays
• Steroid injections.

The best initial treatment is to inject long-acting cortisone (steroid) into the keloid once a month. Keloids are very difficult to treat with recurrences commonly occurring. Earlobe keloids are often excised surgically followed with several injections of steroids. In severe cases surgically excising the keloid might be an option, but operating on a keloid usually stimulates more scar tissue to form.

Conclusion
Keloids are a skin disorder that is largely considered a cosmetic problem. There are no reports of keloids being cancerous although some can become very large and unsightly. Some individuals are more prone to keloids than others. Prior to surgery knowledge of this might lead the surgeon to alter his or her techniques to prevent keloid formation. Keloids are notoriously difficult to treat once they have formed.

Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. Dr. Brett Hodge is an obstetrician/gynaecologist and family doctor who has over twenty years in clinical practice. Dr. Hodge has a medical practice in the Johnson Building in The Valley.

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