Keloid scars: Signs and symptoms
Where do keloids develop on the body?
Most develop in one of these areas:
Ear or earlobe
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:
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.
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.
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.
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.
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.
Once a keloid stops growing, it tends to remain the same size. Unlike other scars, a keloid rarely fades without treatment.
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.
A keloid can range from the size of a pimple to larger than a football.
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.
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.
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.
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.
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.
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 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.
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 al. Dermatology 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.
Paula Ludmann, MS
Arturo R. Dominguez, MD, FAAD
Ivy Lee, MD, FAAD
Last updated: 8/30/22