If you’ve ever developed a keloid scar, you know how terrible it can look and how difficult it is to treat.
Skin of color is susceptible to this type of scar and the darker the skin, the more likely there will be a chance of hypertrophic or keloid scarring. Both are raised scars caused by an abnormal overgrowth of skin tissue as a wound heals. Keloid formation is wound healing that just keeps going and going like the Energizer bunny, but it's not cute.
Keloids can be caused by acne, minor burns, cuts, scrapes, or scratches. Unlike normal and even hypertrophic scars, keloid scars extend beyond the original wound site and into the surrounding area. How keloid scars develop in terms of size, dimension and severity can depend on the seriousness of the injury and where it is located. Keloids are thought to be hereditary and tend to run in families.
Keloids are difficult to treat and they don’t go away on their own. Once a keloid forms, you can’t completely eliminate the scar, though if treated early, it’s possible to diminish the appearance. If you know you are prone to keloidal scarring, there are steps you can take to minimize the chance of their formation.
1. Avoid Shaving
Avoid or be careful when shaving to prevent nicks and cuts.
2. Take Care If You Have Acne
If you have acne, don’t pop pimples and maintain a proper skincare regimen. See a dermatologist in order to keep acne under control. Serious acne lesions might develop into keloid scars that can be worse than acne.
3. Avoid Body Piercings and Tattoos
Keloids might develop on the earlobes from simple ear piercings, body piercings, as well as tattoos.
4. If Possible, Avoid Cosmetic Surgery
If you will be having a surgical procedure done and are prone to keloid scarring, let the surgeon know and discuss what can be done to minimize scarring. There are things that a surgeon will be able to do to try to avoid keloids, including cortisone injections into the wound area and using Steri-Strips to keep tension off the wound. Be sure to follow post-operation directions.
5. Treat Injuries and Burns Immediately
Keep wounds clean by using gentle cleansers without harsh or irritating ingredients. Try running cool water over burns or using a cool compress. For serious burns or injuries, see a doctor.
6. Keep the Wound Moisturized
Moisturize the wound to try to prevent the scar from drying up and possibly reopening. To help moisturizers absorb and soothe wounds, heat up a wet washcloth in the microwave to apply moist heat (not too hot) to the injured skin and follow with a gentle moisturizer.
7. Massage the Scar
A massage may assist in softening and healing scars.
8. Herbal and Home Remedies
Over-the-counter and herbal remedies don’t seem to work after a keloid has already formed. Most homemade remedies simply keep the scars lubricated and the skin moist and help lighten darkness caused by the wound. Be sure not to use anything that will further irritate the skin. Also, talk to your doctor before using any herbal remedies on wounds and scars.
- Onion extract (found in Mederma) might work if used immediately on new scars.
- Bulbine frutescens has antibacterial properties and helps decrease inflammatory response and fibroblast production.
- Centella asiatica is a medicinal herb that contains saponins (chemical compounds found in some plants) that assist with wound healing and also inhibits inflammatory response.
What Is a Fibroblast?
A type of connective tissue cell that produces collagen and other proteins found in the extracellular matrix.
Other plant extracts you may try to use before a keloid forms are: centella asiatica and bulbine frutescens. Both are found in Alpha centella cream, which is often used under microporous tape.
Other natural remedies that some have suggested might work to treat new scars include: aloe vera gel, cocoa butter, lavender, calendula, tea tree and castor oil, apple cider vinegar, garlic oil, lemon, and onion juice.
9. Avoid Sun Exposure
Avoid sun exposure and use sunscreen or protective clothing to protect the scar and keep it from further darkening.
10. Heal From the Inside Out
It is also important to eat a nutrient-rich diet and drink healthy fluids to try to help build new tissue and remove toxins.
11. Stop Smoking
If you smoke, stop. Smoking decreases blood circulation in the skin, which contributes to inadequate wound healing and possibly tissue loss.
Andrews JP, Marttala J, Macarak E, Rosenbloom J, Uitto J. Keloids: the paradigm of skin fibrosis - pathomechanisms and treatment. Matrix Biol. 2016;51:37-46. doi:10.1016/j.matbio.2016.01.013
Betarbet U, Blalock TW. Keloids: a review of etiology, prevention, and treatment. J Clin Aesthet Dermatol. 2020;13(2):33-43.
Barara M, Mendiratta V, Chander R. Cryotherapy in treatment of keloids: evaluation of factors affecting treatment outcome. J Cutan Aesthet Surg. 2012;5(3):185-189. doi:10.4103/0974-2077.101376
Shin TM, Bordeaux JS. The role of massage in scar management: a literature review. Dermatol Surg. 2012;38(3):414-423. doi:10.1111/j.1524-4725.2011.02201.x
Draelos ZD, Baumann L, Fleischer AB Jr, Plaum S, Avakian EV, Hardas B. A new proprietary onion extract gel improves the appearance of new scars: a randomized, controlled, blinded-investigator study. J Clin Aesthet Dermatol. 2012 Jun;5(6):18-24.
Gulumian M, Yahaya ES, Steenkamp V. African herbal remedies with antioxidant activity: a potential resource base for wound treatment. Evid Based Complement Alternat Med. 2018;2018:4089541. doi:10.1155/2018/4089541
Somboonwong J, Kankaisre M, Tantisira B, Tantisira MH. Wound healing activities of different extracts of Centella asiatica in incision and burn wound models: an experimental animal study. BMC Complement Altern Med. 2012;12:103. doi:10.1186/1472-6882-12-103
de Araújo R, Lôbo M, Trindade K, Silva DF, Pereira N. Fibroblast Growth Factors: A Controlling Mechanism of Skin Aging. Skin Pharmacol Physiol. 2019;32(5):275-282. doi: 10.1159/000501145.
Commander SJ, Chamata E, Cox J, Dickey RM, Lee EI. Update on postsurgical scar management. Semin Plast Surg. 2016;30(3):122-128. doi:10.1055/s-0036-1584824
McDaniel JC, Browning KK. Smoking, chronic wound healing, and implications for evidence-based practice. J Wound Ostomy Continence Nurs. 2014;41(5):415-E2. doi:10.1097/WON.0000000000000057