Keloids: Winning Strategies for Darker Skin

Can anyone get keloids?Yes.
Are they more likely in darker skin tones? Yes.
Can I prevent keloids? There are actions you can take to reduce the likelihood of occurrence.
Don’t they only happen with surgery?No. Keloids can be associated with any kind of skin injury or damage.
Is there a cure?There are many treatment and management options. We discuss some of them in this blog. Unfortunately Keloids also have a tendency to reoccur.

Like dealing with dark spots wasn’t enough, those of us with darker skin, may also need to contend with Keloids. Argue with your neighbors but keloids are more common in individuals with darker skin. They are doubly challenging because they can grow beyond the original wound and possibly recur after treatment.

Keloids are a type of scar that grows unexpectedly and can be triggered by any skin damage. These scars form as a result of an overactive healing process, where the body produces more collagen than needed. The exact cause of keloids is still not 100% agreed on, but it’s known that injuries such as piercings, cuts, and even minor skin abrasions can lead to their development.

Because of how likely it is to reoccur, your first and primary strategy is prevention.

  • What Causes Keloids? Keloids can develop from any skin injury, including surgical scars, acne, and piercings. Sometimes, they form without any noticeable injury, termed “spontaneous keloids’. These are rare but shows that even minor, unnoticed skin damage can trigger their growth.

  • Treatment Challenges: Treating keloids is complex, especially in darker skin, due to the risk of pigmentation changes. Treatments vary in effectiveness and often require a combination of approaches to manage symptoms and reduce the likelihood of recurrence.

  • Melanin Risk Factors: Certain individuals are at a higher risk of developing keloids, including those of African, Asian, or Latin-American descent, individuals with a family history of keloids, and those within the age range of 10 to 30 years. Pregnancy and hormonal changes can also increase the risk.

Treatment strategies aim to reduce their size, improve appearance, and alleviate any discomfort they may cause. Here’s a summary of the current treatment options based on the latest research and expert recommendations:

  • Cryotherapy: This involves freezing keloids with liquid nitrogen, which can be effective especially for smaller keloids. However, multiple treatments may be necessary, and there’s a risk of hypopigmentation, particularly in darker skin​​.
    • Laser Therapy: Pulsed-dye laser therapy can flatten larger keloids and help with symptoms like itchiness. It’s usually delivered over several sessions. Combining laser therapy with cortisone injections might be recommended, though side effects like pigment changes can occur​​.
      • Radiation Therapy: Used alone or post-surgery, low-level X-ray radiation can shrink keloid tissue. While effective, it carries a long-term risk of skin complications and cancer​​.
      • Surgical Removal: Surgery might be an option if keloids don’t respond to other treatments, often followed by other methods to reduce the high recurrence rate​​.
      • Corticosteroid Injections: These are commonly used to shrink keloids, with many patients experiencing significant improvement. However, keloids may regrow, and there’s a possibility of light spots forming at the injection sites in darker skin​​.
      • Pressure Garments: After keloid surgery, wearing pressure garments can help prevent the keloid from returning​​.

      There are varying degrees of success and risk of keloid recurrence. The choice of treatment depends on several factors, including the keloid’s location, size, previous treatment responses, and the patient’s skin type.

      Research into keloid treatment is ongoing, with studies exploring options like botulinum toxin type A (Botox) for wound healing, genetic markers in keloid tissue, and stem cell therapy. These potential treatments show promise for more effective keloid management in the future​​.

      Managing keloids at home is really all about wound care, applying corticosteroid creams or silicone gel, avoiding skin irritation, and protecting the skin from the sun. These steps can help prevent keloid formation.

      Don’t be a hero. Managing keloids effectively requires understanding their unique behavior in darker skin tones, acknowledging the limitations and potential side effects of current treatments, and working closely with a dermatologist.

      A tailored approach, often combining multiple therapies, offers the best chance for symptom relief and aesthetic improvement.

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