A keloid, or keloid scar, is a kind of overgrown scar, or an overly aggressive healing response to a wound.

Scars, which form as a response to a wound such as a minor burn, cut, or abrasion, are part of the body’s natural healing process. In most cases, scars usually grow smaller and fade over time, but in some people, the skin can overreact to the damage and lead to scars that are much larger than the original wound. These scars are called keloids.

Keloid scars, which are typically thick and irregular, rarely go away on their own. They can be challenging to treat, which is why dermatologists emphasize the importance of preventing keloids from forming in the first place, according to the American Academy of Dermatology Association (AAD).

Causes and Risk Factors of Keloids

It’s not clear why some people develop keloids, but doctors believe that these types of scars form when fibroblasts — cells found in our connective tissue that secrete collagen — overreact and produce high amounts of collagen in response to a wound, notes Stat Pearls.

If you are prone to developing keloids, any type of skin injury that can cause a scar can lead to the formation of a keloid. Some common causes of keloids include:

  • Surgical cuts or any other types of cuts
  • Acne and chickenpox blemishes or scars
  • Burns
  • Body or ear piercings
  • Tattoos
  • Insect bites
  • Vaccination shots
  • Wearing tightly braided hair

In rare cases, keloids can form on skin that hasn’t been injured. These are referred to as spontaneous keloids.

The AAD identifies the following as risk factors that may increase your odds of developing keloids:
  • Being of African, Asian, or Hispanic Descent
  • Having a Family History of Keloids As many as one-third of people who get keloids have a close relative (such as a parent or sibling) who is prone to keloids.
  • Being Between 10 and 30 Years Old Most people begin to notice keloids developing on their skin in their twenties, although these scars can start earlier or later.

Prognosis of Keloids

While keloids are benign (noncancerous) growths, they are nevertheless difficult to treat and frequently grow back even after they are surgically removed. But your dermatologist may be able to suggest measures that can help reduce the odds of keloids returning after treatment or at least ways to minimize their appearance.

Treatment and Medication Options for Keloids

Keloids generally do not need to be treated. But treatment may be helpful if a keloid scar causes discomfort or hampers movement (if it covers a joint or a large area, for example). People may also seek treatment for a keloid is if the scar impacts their self-esteem and how they feel about their appearance. For instance, if the scar is large or is located in a very visible place on your body, your doctor may be able to help you find ways to reduce the size and prominence of the keloid.

There is no one treatment that works best for all keloids. Dermatologists typically tailor the treatment to the individual based upon factors such as age and type of keloid. Keloids are difficult to banish completely, and using more than one type of treatment often improves results. Dermatologists therefore often recommend two or more types of treatments for their patients.

Treatment options for keloid scars include:

  • Cryotherapy This treatment, which works best on small keloids, involves freezing the keloid from the inside out. This method is often used before or after corticosteroid injections to help make the injections more effective, says the AAD.
  • Pressure Therapy This involves using a device or a special piece of clothing to put pressure on the area and reduce blood flow to the site to inhibit the regrowth of the keloid. While effective, this treatment, which is often used after surgery, can be difficult for many people to stick to. These devices can be uncomfortable, and people need to wear them for 6 to 12 months.
  • Radiation Therapy Low-dose radiation treatment after surgery may help prevent the scar from growing back.
  • Laser Therapy This treatment uses high-energy light beams to reduce the size and lighten the color of a keloid. Laser therapy is commonly combined with other treatments such as corticosteroid injections or pressure therapy.
  • Silicone Gels and Patches These silicone-based treatments help flatten and reduce the size and color of the scars.
  • Ligature Your doctor may opt to use a surgical thread to tie around the keloid, which cuts off the blood supply so that the keloid will naturally fall off after a period of time.
  • Surgery Surgery is typically combined with other therapies such as corticosteroid injections or silicone treatments; that’s because in nearly 100 percent of cases, keloids grow back after surgical removal, according to the AAD.

Medication Options

  • Corticosteroid Injections These injections are administered into the keloid to help reduce inflammation and constrict blood vessels, which may help relieve swelling, itchiness, or tenderness.
  • Fluorouracil This chemotherapy medication, which is usually used to treat cancer, may be used in conjunction with corticosteroids.

Alternative and Complementary Therapies

While there are a number of products on the market that claim to be effective for prevention or treatment of keloids, there isn’t a lot of research that provides solid evidence to support those claims. Here are two alternative and complementary therapies that have some science behind them.

Centella asiatica has commonly been touted as preventing keloids. In a study published in April 2018 in the journal Minerva Chirurgica, researchers analyzed the postoperative scars of 129 patients after they received knee or abdominal surgery.Those who received centella asiatica showed fewer signs of keloid formation compared with those who didn’t receive it. The study researchers also noted that the centella asiatica supplement is safe, doesn’t interfere with other treatments, and is well-tolerated.

Related: What Are 'Natural' Skin-Care Products, and Are They Actually Better for You?

Prevention of Keloids

If you are prone to developing keloids, you’ll want to be vigilant about taking steps to prevent the formation of these scars. Some tips from AAD to keep in mind:
  • Try to avoid body piercings, tattoos, or any elective surgery, as keloids can occur after these procedures.
  • Treat any injury right away, no matter how minor it is; this may help your skin heal faster and reduce your risk of scarring.
  • If you do find yourself with a wound, talk to your dermatologist about how best to care and dress it. This will help you prevent keloid scars from developing.

Research and Statistics: Who Has Keloids?

Keloids are most common in people under age 30, according to the U.S. National Library of Medicine.As mentioned above, they are also more common in people of African American, Asian, or Hispanic descent.

Related Conditions and Causes of Keloids

Some skin conditions can resemble keloids and require a diagnosis from a doctor to identify them. They include:

Hypertrophic Scars Experts differ as to whether these scars are really different from keloids, but there do seem to be some differences.

  • Unlike keloids, which can extend far beyond the injury site, hypertrophic scars don’t grow beyond the boundaries of the original wound. These scars appear in the first weeks after a wound heals and then develop over the next six to eight months, after which they stop. Keloids, on the other hand, begin to grow anytime in the first year after the injury and can continue to spread for months or even years.
  • Hypertrophic scars are not more common in people who have darker skin.
  • Hypertrophic scars respond better to treatment and do not grow back as frequently after surgery as keloids, according to research published in June 2020 in Experimental Dermatology.

Nodular Scleroderma Also known as keloidal scleroderma, nodular scleroderma is rare form of systemic sclerosis, an autoimmune disease that affects the connective tissues. Nodular scleroderma can cause the development of firm plaques or nodules on the skin — typically on the upper trunk, arms, face, and neck — that look like keloids.

Lobomycosis Also known as keloidal blastomycosis or Lobo disease, this chronic fungal skin infection can cause the development of keloid-like lesions. It’s more common in the Amazon region and in South and Central American countries.

Resources We Love

American Academy of Dermatology Association

Dermatologists are the healthcare professionals who can diagnose and treat keloids. This website provides thorough and detailed information about all aspects of keloid scars, from how they form to what you need to know about the latest treatments to remove keloids and reduce their risk of regrowth.

Keloid Research Foundation

This nonprofit medical research and educational foundation aims to foster scientific research in keloid disorder and promote education and advocacy to those who are prone to developing these types of scars. On their website, you can find patient stories, educational resources, information about the latest research, and much more.

NYU Langone

The New York University’s Langone Health website is full of in-depth information on keloids and other scars. If you’re looking for detailed information on diagnosis, treatment, surgery, recovery, and support, this is a great resource.

Editorial Sources and Fact-Checking

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  • Keloids: Diagnosis and Treatment. American Academy of Dermatology Association.
  • Keloids: Overview. American Academy of Dermatology Association.
  • Keloids: How to Prevent These Raised Scars. American Academy of Dermatology Association.
  • Keloids: Who Gets and Causes. American Academy of Dermatology Association.
  • Keloids. MedlinePlus. December 3, 2020.
  • McGinty S, Siddiqui W. Keloid. StatPearls. August 16, 2020.
  • Cotellese R, Hu S, Belcaro G, et al. Centella Asiatica (Centellicum) Facilitates the Regular Healing of Surgical Scars in Subjects at High Risk of Keloids. Minerva Chirurgica. April 2018.
  • Tulandi T, Al-Sannan B, Akbar G, Ziegler C, et al. Prospective Study of Intraabdominal Adhesions Among Women of Different Races With or Without Keloids. American Journal of Obstetrics and Gynecology. February 2011.
  • Limandjaja G, Niessen F, Scheper R, Gibbs S. The Keloid Disorder: Heterogeneity, Histopathology, Mechanisms and Models. Frontiers in Cell and Developmental Biology. May 26, 2020.
  • Limandjaja G, Niessen F, Scheper R, Gibbs S. Hypertrophic Scars and Keloids: Overview of the Evidence and Practical Guide for Differentiating Between These Abnormal Scars. Experimental Dermatology. June 1, 2020.


  • Keloids. Yale Medicine.
  • Symptoms of Keloids. Northwestern Medicine.
  • Medical Treatment for Scars and Keloids. NYU Langone Health.
  • Mari W, Alsabri S, et al. Novel Insights on Understanding of Keloid Scar: Article Review. The Journal of the American College of Clinical Wound Specialists. December 2015.
  • Juckett G, Hartman-Adams H. Management of Keloids and Hypertrophic Scars. American Family Physician. August 2009.


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