Keloid ScarsWhat it is, and what we can do about it.

What a keloid is

When skin is wounded, the body repairs it by laying down collagen, then remodelling that collagen over the following months so the scar gradually flattens and settles. A keloid is what happens when the first half of that process keeps going and the second half does not properly take over.

The result is a scar built from dense, disorganised excess collagen that does not stop at the wound edge. It expands sideways into healthy skin, which is the defining characteristic and the one that separates a keloid from every other kind of scar. Keloids are typically raised, firm, smooth and shiny, often darker or redder than the surrounding skin, and frequently itchy or tender.

They do not regress on their own. Left alone, a keloid may continue to enlarge slowly for months or years.

Keloid or hypertrophic scar

These get used interchangeably and should not be.

A hypertrophic scar is raised and often red, but it stays within the footprint of the original injury. It is a common outcome after burns, surgery and wounds under tension, and it usually improves substantially on its own over a year or two.

A keloid grows beyond the original wound, does not settle spontaneously, and has a strong tendency to recur if removed.

The practical importance is expectation. A hypertrophic scar has time on its side. A keloid does not.

Who develops them

There is a clear genetic component, and keloids are markedly more common in people with richly pigmented skin, particularly of African, Asian and Hispanic descent. If your parents or siblings form keloids, your own risk is higher.

Certain sites are far more prone than others. Earlobes after piercing are the classic example, along with the chest, shoulders, upper back and jawline. Acne on the chest and back is a common precursor, as are surgical incisions, burns, vaccination sites and even minor scratches in susceptible people.

Why this page exists, and what we can honestly offer

We want to be direct about scope, because keloids are an area where overpromising is common and harmful.

Established keloid management is largely physician-led. Intralesional corticosteroid injection, surgical excision combined with adjuvant treatment, cryotherapy, pressure therapy and radiotherapy are the treatments with a meaningful evidence base, and they are not on our service menu. We are not going to sell you a course of aesthetic treatments for a keloid and let you find out later that it was never the right approach.

What we do offer is genuinely useful.

Assessment. We will look at your scar, tell you honestly whether it looks like a keloid or a hypertrophic scar, and explain what that means for your outlook.

Referral. Where medical management is appropriate, we will direct you to it. Bradford Skin Clinic & Medical Spa is nurse-practitioner-led, and our Medical Director, Alex Dinovich, FNP-PHC, is an authorised prescriber, so that initial clinical conversation can happen here rather than nowhere.

Screening before our own treatments. This is the part that matters most to our own patients. A number of the treatments we offer work by creating controlled injury to the skin. Microneedling, CO2 laser resurfacing, thread placement and any procedure that breaches the skin all carry a different risk profile in someone who forms keloids. We ask about it, we take the answer seriously, and where the risk is not acceptable we will recommend against a treatment even if you have come in specifically for it.

Prevention advice. If you know you are keloid-prone, the most effective intervention is avoiding unnecessary wounds in high-risk sites, and managing any unavoidable wound carefully and early.

If you have a raised scar and are not sure what it is, book an assessment. We will tell you what we think it is and what the sensible next step is, even when that step is not with us.