HKSH Health Series

Say Goodbye to Keloids - Dr. CHOI Wing Kee



Q1. Are keloids malignant tumours?

Most people with keloids are worried about malignant tumours. In fact, a keloid is just a benign scar. It has to do with overproduction of collagen caused by the overgrowth of fibroblast, which results in abnormal scar formation. Patients may experience itchiness, pain, swelling, or even discomfort.

Unlike normal scars, keloids tend to grow beyond the original wounds as lumps. That’s why they are often mistaken for tumours.

 
Q2. Nobody has keloids after ear piercing but me. Why?
Most people have no scars after ear piercing. For those with a related family history, keloids may grow not only on ears but also the shoulders, chest, etc.

We believe that keloids are genetically-related, and more common in coloured people, e.g. Asians and Africans. They are less common in white people. Not everyone has keloid scars after ear piercing.

 
Q3. Does steroid injection cause any serious side effects?
As treatment of keloids, steroids are only injected into the keloids, not blood vessels. There should be no severe systemic side-effects like excessive weight gain, a round face, etc. But sometimes local side effects may occur, such as minor skin atrophy, lighter skin colour, or dilated blood capillaries, etc. Therefore we need to be careful with the dosage.
 
Q4. Can laser treatment flatten keloids?
There are different types of medical lasers. And keloids are mostly treated by dye laser. By targeting haemoglobin and causing vasoconstriction, dye laser can relieve redness and swelling. Rather than a cure, however, dye laser alone can provide only symptom relief.
 
Q5. Can surgical excision remove keloids for good?
As keloid treatment, mere surgical excision may increase the risk of local recurrence. Sometimes the keloid may even grow back larger than the original. Therefore, adjunctive treatments are usually required, e.g. steroid injection, pressure garment, even post-surgical radiotherapy to reduce the chance of local recurrence after surgery.
 
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