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Keloids: Who gets and causes

Who gets keloids?

Men and women worldwide develop these raised scars. Some people, however, have a higher risk of developing a keloid when they scar. You’re more likely to develop a keloid if you have one or more of the following:

  • African, Asian, or Hispanic descent. The keloid is the most common skin condition among ethnic Chinese in Asia. In the United States, keloids are more common in African Americans and Hispanic Americans than whites.

  • Family history of keloids. About 1/3 of people who get keloids have a first-degree blood relative (mother, father, sister, brother, or child) who gets keloids. This family trait is most common in people of African or Asian descent.

  • Between 10 and 30 years of age. This is the peak time to develop keloids. Most people begin seeing keloids in their 20s. Although keloids can develop earlier or later, children and the elderly rarely get a keloid when they scar.

Some people are more likely to get keloids. Young adults who have dark skin are more likely to develop a keloid.

Two African American young adults working in library

What causes keloids?

Most people get these scars after they injure their skin, such as from a cut or puncture wound. Getting a tattoo or piercing can also cause a keloid.

Sometimes, a surgical scar turns into a keloid. Some women who have had a cesarean section (C-section) or hysterectomy get keloids after the surgery.

Some people get keloids when serious acne clears or chickenpox fade. It’s also possible to get a keloid after getting an insect bite or shot for a vaccine.

Wearing tightly braided hair causes keloids in a few people.

Some men who shave their face develop keloids in their beard area.

It’s also possible for keloids to form on uninjured skin. These keloids are called “spontaneous keloids.” They usually appear on the chest and develop in people who have a family history of developing keloids. When keloids develop spontaneously, it’s more likely that several keloids will appear.

It’s still not clear why some people’s skin scars this way.

To discover why some people develop keloids, dermatologists continue to study these scars. Finding the cause could lead to better treatment and more-effective ways to prevent keloids.

Getty Images

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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.

Madu P and Kundu RV. “Follicular and scarring disorders in skin of color: presentation and management.” Am J Clin Dermatol. 2014 Aug;15(4):307-21.