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Keloid scars: Signs and symptoms


Where do keloids develop on the body?

Most develop in one of these areas:

  • Ear or earlobe

  • Jawline

  • Chest

  • Upper back

  • Shoulder

Because a keloid develops after you injure your skin, you can get this scar elsewhere. For example, a woman who has keloid-prone skin can develop a keloid on her belly after having a cesarean section (C-section), hysterectomy, or other surgery in this area.

Navel piercing can also cause a keloid on the belly.

Men who have darkly pigmented skin and shave their beard area may develop keloids on their face.

It’s rare for a keloid to develop on the genitals, palms, soles, or tongue.

How do keloids develop?

You’ll likely notice one or more of the following, as this scar forms:

Appears slowly

After you injure skin, it’s likely to take 3 to 12 months or longer to see the first signs of a keloid. The first sign is usually thickening skin. About 20% of keloid scars appear more than a year after the injury.

Side view pages of a calendar

Grows

When it began, the keloid on this girl’s earlobe looked like a pimple. It continued to grow. Most keloids continue to grow for weeks or months after they appear. A few grow for years. Growth tends to be slow. Occasionally, a keloid grows quickly.

Keloid scar from ear piercing

Causes pain, itch, or burning

While a keloid is growing, it may feel tender or painful. It may itch or cause a burning sensation. Symptoms tend to end when the keloid stops growing, but not always. This man developed keloids on his face after chickenpox cleared. Decades later, the keloids still itch and feel painful.

Keloid scars from chickenpox

Changes color

The color of a keloid, like the one on this patient’s shoulder, can differ from that of your natural skin color. When a keloid first appears, it’s often red, pink, or slightly darker than your natural skin tone. As it grows, it may darken. Some become lighter in the center and darker at the edges.

Keloid scar on shoulder

Darkens after spending time in the sun

Some people say their keloid darkens noticeably after they spent time in the sun. This darkening can be permanent.

Woman standing in bright sunlight shielding her eyes

Stops growing

Once a keloid stops growing, it tends to remain the same size. Unlike other scars, a keloid rarely fades without treatment.

Keloid scar on ear


Keloids have different shapes, sizes, and textures

The keloid you see on your skin can look different from the keloid you see on someone else’s skin. Sometimes, one keloid on your skin will look very different from another. The following pictures of keloids show how different keloids can look.

Shape of keloids varies

Most keloids are either round, oval, or oblong. On the chest, arms, or legs, this scar is usually raised and has a flat surface. A keloid on the ear, neck, or belly may hang from the skin.

Keloid scars on chest

Size differs

A keloid can range from the size of a pimple to larger than a football.

Keloid scar on underside of earlobe

Texture often hard and rubbery or soft and doughy

When you touch a keloid, you’re most likely to feel one of these textures. A few keloids have a texture that’s somewhere in between hard and soft.

Large keloid scar on earlobe

Number of keloids varies

Most people develop one or two keloids. Some people get several. You’re more likely to develop many keloids after acne or chickenpox clears, but not always. The girl in this picture developed two keloids after chickenpox cleared.

Keloid scars on face


Problems that keloids can cause

While most keloids are harmless, they can interfere with your life. A keloid can:

Restrict how far you can move or stretch

When a keloid covers a large area or develops over a joint, the hardened, tight scar tissue often limits how far you can move. If this happens, it may affect your ability to reach, walk, and do other activities.

Keloid scar causing painful shoulder

Bleed or become infected

A keloid rarely opens upon its own. Like the rest of your skin, you may see a keloid bleeding if you injure it. An open keloid can become infected. If the wound on a keloid fails to heal, see a dermatologist.

Holding cotton pad on keloid to stop the bleeding

Leave you feeling sad or upset

Having a keloid can be hard on your self-esteem. These scars can be noticeable. Most people who seek treatment for a keloid do so because they dislike what it looks like.

Sad woman sitting alone on the floor

When people see a dermatologist for treatment, they often ask what caused them to get this scar. You’ll find out what causes these scars at Keloid scars: Causes.


Images
Images 1, 5, 11-13: Getty Images

Images 2, 7, 9, 10: Used with permission of the American Academy of Dermatology National Library of Dermatologic Teaching Slides.

Images 3,4: Used with permission of the Journal of the American Academy of Dermatology and JAAD Case Reports:

  • JAAD Case Reports 2019;5:787-8.

  • JAAD Case Reports 2019;5:840-3.

Image 6,8: Used with permission of DermNet NZ.

References
Chike-Obi CJ, Cole PD, et al. “Keloids: pathogenesis, clinical features, and management.” Semin Plast Surg. 2009;23(3):178-184. doi:10.1055/s-0029-1224797.

Daggett A, Congcharoen J, et al. “Top 10 things you need to know about keloids and their treatment.” J Miss State Med Assoc. 2016;57(4):108-11. Kelly AP, Bayat A. “Keloids” In: Kelly AP, Taylor SC, et alDermatology for Skin of Color [2nd ed]. The McGraw Hill Companies, United States of America, 2016.208-22.

Monstrey S, Middelkoop E, et al. “Updated scar management practical guidelines: Non-invasive and invasive measures.” J Plast Reconstr Aesthet Surg. 2014 Aug;67(8):1017-25.


Written by:
Paula Ludmann, MS

Reviewed by:
Arturo R. Dominguez, MD, FAAD
Ivy Lee, MD, FAAD

Last updated: 8/30/22

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