Keloids: How to prevent these raised scars

If you have (or had) a keloid, you have a higher risk of getting another one. You also have a higher risk if one (or more) of your parents, siblings, or children has (had) a keloid.

The good news is that there are things you can do to reduce your risk of getting a full-blown keloid. Below you’ll find four common causes of keloids and what you can do to prevent each from causing a keloid.

1. Ear piercing: Pay close attention to your ears after getting a new piercing. If you notice the skin on an earlobe start to thicken, you may be able to prevent a keloid if you act quickly. At the first sign of thickening, immediately remove the earring and start wearing a pressure earring instead.

To get the best results, you’ll need to wear the pressure earring for at least 12 (and preferably 20) hours a day for 4 to 6 months. You’ll find pressure earrings available online.

Because you cannot wear another earring under a pressure earring, your pierced hole will likely close if it’s new. Dermatologists caution against getting your ears pierced again. You’ll likely develop another keloid.

   This keloid developed after she had her ears pierced. Wearing a pressure earring immediately after she noticed her skin start to thicken may have prevented this keloid.

   

2. Tattoo, body piercing, or cosmetic surgery: Try a test spot first. You can see how your skin will heal by getting a small amount of work done in a test area first. If the skin in the test area starts to thicken, you’ll know that the work could cause a keloid.

Wearing a pressure garment can prevent thickening skin from turning into a keloid. To be effective, you need to start wearing it as soon as you notice thickening skin. A dermatologist can fit you with a pressure garment. Other treatment may also help.

3. Surgery: If you have (or had) a keloid, tell your surgeon before the surgery. There may be a technique that your surgeon can use to reduce the likelihood that you’ll develop a keloid after surgery.

If you notice the surgical scar thickening, starting keloid treatment immediately may help prevent a keloid. A dermatologist can create a keloid treatment plan for you.

4. Injured skin: Follow these wound-care tips. The right wound care can reduce your risk of developing a keloid after you injure your skin.

Supplies you need
If you injure your skin, you’ll want to get the following:

   • Sterile petrolatum gauze
   • Hydrogel wound dressing
   • Silicone sheets or gel
   • Sunscreen with SPF 30, broad-spectrum protection, and water resistance
   
Wound care
   • Wash the area immediately with soap and water. Keeping the wound clean helps to reduce scarring. When cleaning the wound, you want to avoid using hydrogen peroxide, rubbing alcohol, or iodine. These can be too drying. Soap and tap water or saline solution will cleanse without drying the wound.
   • Bandage the area with sterile petrolatum gauze. You want to keep wounds moist.
   • Gently cleanse the wound every day until it heals. You want to avoid scrubbing, which can cause a scar.
   • Protect the wounded skin from the sun. Studies show that ultraviolet (UV) light from the sun can increase scarring and darken the scar. You can prevent this by covering the newly wound skin with a bandage and clothing.

Keloids can take time to appear. UV light from the sun can cause healed skin to darken and thicken. Once the wound heals, wearing sunscreen can help prevent this. You’ll want to apply the sunscreen when the wound isn’t covered by clothing or a silicone sheet.

To get the protection you need, use a sunscreen that offers SPF 30 or higher, broad-spectrum protection, and water resistance.
   • As soon as the wound heals, begin using silicone sheets or gel. Applying silicone sheets or gel can help prevent keloids from forming and reduce the size of existing scars. You can buy these products without a prescription.

   If you have a severe injury like a bad burn, seeking medical care can give you the best outcome.

   

Partner with a board-certified dermatologist

These doctors are the skin experts. If you are concerned about thickening skin or an existing scar, a dermatologist can create a treatment plan tailored to your needs.

Images
Image 1: Used with permission of the American Academy of Dermatology National Library of Dermatologic Teaching Slides.

Image 2: Getty Images

References
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.

Meaume S, Le Pillouer-Prost A, et al. “Management of scars: Updated practical guidelines and use of silicones.” Eur J Dermatol. 2014;24(4):435-43.

Monstrey S, Middelkoop E, et al. “Updated scar management practical guidelines: Non-invasive and invasive measures.” J Plast Reconstr Aesthet Surg. 2014;67(8):1017-25.

Son D and Harijan A. “Overview of surgical scar prevention and management.” J Korean Med Sci. 2014; 29(6): 751–757.

Tanaydin V, Beugels J, et al. “Efficacy of custom-made pressure clips for ear keloid treatment after surgical excision.” J Plast Reconstr Aesthet Surg. 2016;69(1):115-21.