A keloid is a type of raised scar that develops after skin injury. These growths are benign and do not transform into cancer. Understanding keloids involves recognizing their unique characteristics as an abnormal response to wound healing, distinct from malignant conditions. This knowledge can help alleviate concerns about their nature and guide appropriate management approaches.
Understanding Keloids
Keloids form when the body produces an excessive amount of collagen during the wound healing process. Collagen is a protein that provides structure and strength to the skin; its overproduction leads to these distinct scars. Keloids often present as firm, rubbery, raised, and shiny lesions that can be pink, red, purple, brown, or darker than the surrounding skin, depending on an individual’s skin tone.
These scars commonly appear on areas such as the chest, shoulders, earlobes, and upper back, which are regions prone to skin tension. They can develop months to years after a skin injury, which might include cuts, burns, acne, insect bites, injections, or even minor scratches. Unlike typical scars that remain confined to the original wound boundary, keloids are notable for growing beyond these margins.
Individuals with keloids may experience symptoms such as itching, pain, or tenderness. The texture of a keloid can vary from soft and doughy to hard and rubbery. If a keloid forms near a joint, its size and firmness can sometimes restrict movement or cause discomfort.
Keloids Are Not Cancer
Keloids are classified as benign fibroproliferative dermal scars. While they involve an abnormal and uncontrolled proliferation of cells, specifically fibroblasts which produce collagen, this process is self-limiting and does not represent malignant cell transformation. The growth of keloids is typically confined to the area of the original skin injury and, notably, they do not metastasize or spread to other parts of the body, a defining characteristic of cancerous tumors.
Keloids are composed of normal collagen and fibroblasts, just in excessive amounts, distinguishing them from cancerous growths where cells undergo uncontrolled and abnormal changes. Although keloids share some characteristics with tumors, such as aggressive local growth and resistance to treatment, they are not true neoplasms. Some studies have explored potential links and shared biological pathways between keloids and certain benign or malignant mesenchymal tumors, but this does not mean keloids are cancer or will become cancer.
It is important to differentiate keloids from other skin conditions, including hypertrophic scars, which are also raised but remain within the boundaries of the original wound and may fade over time. While there are rare case reports of skin cancers developing in chronically traumatized keloids, this is not a direct transformation of the keloid itself into cancer. The fundamental distinction remains that keloids are an overgrowth of scar tissue, not a malignant proliferation of cells with the ability to invade distant tissues.
What to Do About Keloids
The diagnosis of a keloid is often made through a visual examination by a healthcare professional. If the appearance is unusual or other skin conditions need to be ruled out, a skin biopsy may be performed to examine a small tissue sample under a microscope. This process helps confirm the benign nature of the growth.
Individuals should seek medical advice if they suspect they have a keloid, especially if it changes in appearance, causes significant discomfort like persistent itching or pain, or if there are cosmetic concerns. Early consultation can help in managing symptoms and potentially limiting the keloid’s growth.
Management options for keloids are primarily aimed at reducing symptoms or improving their appearance. Common approaches include:
- Corticosteroid injections directly into the keloid, which can help flatten it and reduce itching.
- Cryotherapy, which involves freezing the scar with liquid nitrogen, can also reduce its size and hardness.
- Laser therapy may be used to reduce the keloid’s height and fade its color.
- Surgical removal is another option, though it carries a risk of recurrence, sometimes resulting in a larger keloid, so it is often combined with other treatments like steroid injections or radiation therapy to reduce this risk.