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What are Keloids?!

Every industry has a vocabulary of its own and piercing is no different. We have things like circular barbell shafts, insertion tapers, septum clamps, and keloids. You’re not likely to hear of these things outside the piercing world. Our clients can be very creative when describing their piercing problems. The words “infection” and keloid,” for example, are used to describe almost every piercing issue and are almost never what’s actually happening. The most common scarring we see with piercings is hypertrophic but we also see hypergranulation and atrophic as well. To many clients, they’re all keloids. But, what are keloids, really?

From Wikipedia, the free encyclopedia
“Keloid, also known as keloid disorder and keloidal scar,[1] is the formation of a type of scar which, depending on its maturity, is composed mainly of either type III (early) or type I (late) collagen. It is a result of an overgrowth of granulation tissue (collagen type 3) at the site of a healed skin injury which is then slowly replaced by collagen type 1. Keloids are firm, rubbery lesions or shiny, fibrous nodules, and can vary from pink to the color of the patient’s flesh or red to dark brown in color. A keloid scar is benign and not contagious, but sometimes accompanied by severe itchiness, pain,[2] and changes in texture. In severe cases, it can affect movement of skin. Keloid scars are seen 15 times more frequently in people of African descent than in people of European descent. Keloids should not be confused with hypertrophic scars, which are raised scars that do not grow beyond the boundaries of the original wound.”

what are keloids

This image image shows a true keloid. You can clearly see the scar tissue has outgrown the site of the wound and continued to grow. Unlike the common scars, this may not disappear. A simple google image search can show you just how bad keloids can be.

Treating Keloids

Be aware the larger a keloid is allowed to grow the more difficult it will be to treat. Cortisone and steroid injections are the first treatments for Keloids, but require several injections over many weeks or even months.This doesn’t usually make a big impact on keloids, but it’s the least invasive option so it’s where doctors will start.

Surgery is the next option and while it’s more effective than injections there’s a great chance of a keloid returning and growing even larger. If not all the keloid tissue is removed you can be sure you’ll have the same problem again. If you have one keloid removal surgery you’ll likely have another. Other lesser used strategies to remove keloids are laser treatments, silicone sheetings, cryotherapy, interferon, radiation, and even anti-cancer chemotherapeutic agents. Most of these additional treatments are harsh and not not used unless steroid injections and surgery have both failed.

If you see a doctor regarding a scar you suspect may be a keloid they may do a biopsy to be analyzed by a lab. Before this remember that a keloid is a scar that outgrows the shape and site of the wound. It will continue to grow, sometimes to a very large size. Keloids may eventually stop growing on their own, but will never regress without treatment making it very different than the other types of scars. If you ever have scarring with your piercings don’t be alarmed, it’s not likely a keloid. If your scar seems to improve at any point without medical intervention then you know it’s not a keloid. Always visit a studio you trust with your piercing concerns.

John Johnson
John Johnson is a professional body piercer at New Flower Studio in Long Beach, CA. He's also a Red Cross instructor and authorized OSHA trainer. He manages the online curriculum for the Association of Professional Piercers and is a member of ASTM International.