What to do about a keloid on your skin

Imagine you have a small scar, perhaps where you got a courtesy mark or very bad acne on your chest or shoulder. At first, nothing happened; the wound closed on its own and everything was fine. But suddenly, that spot starts to rise higher than the edge of the original wound. It becomes thicker, redder, and has that hard texture that scares you because it won’t open with a shirt or bra. It’s common to feel frustrated when something you thought was over starts growing again. You feel your clothes don’t fit well and you feel embarrassed in the mirror.

That is exactly what happens when you have a keloid. Your body reacts in an exaggerated way to close the wound, but instead of leaving a flat line, it generates new tissue that invades the surrounding area. This is very common in people with brown skin or high melanin because their cells produce more collagen, the protein that gives structure to the skin. The inflammation doesn’t stop when the wound seems closed; it continues to create excess tissue.

What we do in consultation is check if that growth is a keloid or a hypertrophic scar, because they often look very similar. The technical difference is important: keloids do not respect the boundaries of the wound, while hypertrophic scars usually stay within those edges. If this happens to you, don’t worry so much about the technical name and more about how it affects your quality of life.

Why it grows and the myth of melasma

People believe a keloid disappears with a miracle treatment or that it heals on its own if you stop touching it. The reality is that keloids are a chronic condition that is controlled, not one that disappears forever. It’s like a plant that is growing very strong in your skin; with appropriate therapy, you can stop its growth and soften it, but it may reappear if you don’t maintain it or if there are factors that feed it.

The main cause is an unregulated inflammatory response from your macrophages, the cells responsible for cleaning damaged tissue. When there is an excess of this activity, the body releases too many signals to manufacture type I and III collagen. Additionally, TGF-beta receptors, which regulate this healing process, work with more force in darker skin tones. That is why many patients with brown skin present these lumps in the clavicle area or lower back, places where constant friction stimulates that excessive production.

How we solve it together

When you come to your appointment, we first take a photo of your area and measure the thickness of the lump to see how much it has grown. Then, we evaluate if there is pain, if it itches a lot, or if the skin is becoming inflamed. If the keloid is small and very bothersome due to what it causes, sometimes we can try an infiltration with a local anesthetic mixed with a corticosteroid. This calms the inflammation from the inside and reduces collagen production in that specific area.

If the lump is large or has grown too much, our strategy is usually more aggressive to achieve quick results. We perform a surgical excision, which is cutting the excess tissue with a scalpel or laser. But here comes the important part: we don’t leave it at that. If we only cut without treating the root cause, it will grow back just as large. That is why we combine surgery with fractional CO2 laser to remodel the skin and leave it softer and flatter from the inside.

At Verassere, we understand that every patient is different and that not everyone needs the same thing. If you feel comfortable with our approach, we could schedule a session where we apply these combined techniques to improve your appearance and confidence. You can find more information about our treatments in our online store to see what options we have for you.

When to see a dermatologist

You should consider an appointment if you notice that a scarred lump is expanding after several months of having closed a wound. If you feel that it hurts when you touch it, if you see that it changes color to intense red, or if you notice that it irritates you with clothes or sweat. Also, if you see that new lumps are appearing near the original place, which indicates that the inflammation is still active. You don’t need to go if it is already a very large lump, but you should if it starts to bother you or if you are concerned about its appearance.

Frequently asked questions

Why does my keloid not stay the same and keep growing? Can it be completely removed with a single laser treatment? Are there ways to prevent it from coming back after surgery?

Closing

If you want an evaluation before deciding on the best plan for your skin, write to us: Schedule a consultation.