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Keloids: Signs and symptoms


What you see on the skin

If you develop a keloid, you’ll likely notice one or more of the following signs and symptoms. Keloids tend to:

  • Appear slowly. It can take 3 to 12 months or longer to see the first signs of a keloid. Most appear within a year of whatever caused the skin to scar.

    Keloid on a girl’s earlobe. After getting her ears pierced, this raised scar slowly developed.

  • Begin as a raised pink, red, or purple scar. If the keloid appears on the earlobe, it’s likely to be round or oval. On the chest, legs, or arms, a keloid is likely to be a raised scar with a flat surface.

  • Grow slowly. Once you see a keloid, it tends to grow slowly. Most continue to spread for weeks or months. At times, a keloid can grow for years.

    A keloid can also grow quickly. Some triple in size within a few months.

    Keloids on a man’s chest. These keloids appeared slowly after severe acne cleared.

  • Feel soft and doughy or hard and rubbery. When you touch the scar, it will feel different from your surrounding skin. On the earlobe, it’s most likely to feel firm.

  • Cause pain, itch, or tenderness. While a keloid is growing, it can feel itchy, painful, or both. Keloids on the chest are often tender. Once a keloid stops growing, symptoms usually stop.

  • Be fixed in place. Most keloids are solid and won’t move. On the neck, abdomen, or an ear, a keloid may hang by a stalk, so it moves slightly when you touch it.

  • Become darker in color with time. Once a keloid stops growing, it tends to be darker than the person’s skin. The border is usually darker than the center.

    Chest scars: A raised scar (A) rises above the skin; whereas, a keloid (B) rises above the skin and spreads.

Where keloids appear

These scars appear from the head to the feet. Keloids, however, are most likely to develop on the following areas of the body:

  • Ears

  • Neck

  • Shoulders

  • Chest

  • Back

It’s rare for a keloid to form on an eyelid, genital, palm, or sole.

Two keloids on girl’s jawline. These keloids formed where she once had chickenpox.

Size of keloids

These raised scars range in size from smaller than an inch to larger than a football. The largest keloids tend to form on the shoulders and back.

Can take an emotional toll

Keloids can be hard on a person’s self-esteem. These scars can be noticeable. Large ones can limit how much a person can move that area of the body.

Most people who seek treatment for a keloid do so because they dislike how it looks.


Images
Images used with permission of the American Academy of Dermatology National Library of Dermatologic Teaching Slides.

References
Burton CS and Escaravage V. “Hypertrophic scars and keloids.” In: Bolognia JL, et al. Dermatology. (second edition). Mosby Elsevier, Spain, 2008:1498.

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. “Keloids” In Kelly AP, Taylor SC, et al. Dermatology for Skin of Color. The McGraw Hill Companies, China, 2009. 178-94.

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.

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