Overview

Keloids are raised rubbery scars that grow beyond original wound boundaries and continue to expand. Hypertrophic scars are similar but remain within wound margins. Both result from an overactive healing response. Significantly more common in people with darker skin tones, which is a large proportion of Kuwait's and the GCC's population. They can form after surgery, acne, ear piercing, burns, or even insect bites.

Symptoms

• Raised firm scar tissue extending beyond (keloid) or within (hypertrophic scar) wound margins
• Colour: pink, red, purple, or darker than surrounding skin
• Itching, tenderness, or burning; restricted movement if over a joint
• Common locations: earlobes, chest, upper arms, shoulders, face (post-acne)

Causes & Risk Factors

• Overproduction of collagen during wound healing
• Darker skin tone (Fitzpatrick III-VI) — strong risk factor; family history
• Age 15-30 most susceptible; high skin tension on wounds; burns, infections, piercings

Complications

• Restricted joint mobility; significant psychological distress
• Keloids frequently recur after treatment

Diagnosis

Clinical diagnosis based on appearance, location, and history. Biopsy rarely needed.

Treatment

• Intralesional corticosteroid injections: mainstay treatment (multiple sessions)
• Silicone gel sheets or gel: prophylactic and therapeutic
• Cryotherapy; pulsed dye laser or CO2 laser
• Surgical excision must be combined with adjuvant therapy — high recurrence risk alone
• Intralesional 5-fluorouracil or bleomycin; radiation after excision for resistant cases

Prevention

• Those with keloid history: avoid unnecessary piercings, tattoos, elective procedures
• Apply silicone gel sheets to new wounds for 3-6 months
• Control acne aggressively; inform surgeons of your keloid history before any procedure

Ready to take the next step? Book a consultation today