Keloids are thick, raised scars that form when excessive scar tissue develops during the healing process. They can be itchy or tender, and often keep growing well after the wound is closed. While keloids aren’t dangerous, they can be cosmetically troubling and hard to remove.
The good news is that with careful aftercare and simple tricks, you can cut your chances of getting one. Some people are more prone to keloids than others. In fact, studies show keloids are far more common in people with darker skin tones and those with a family history of keloids.
Disclaimer: This is to be used only as an educational piece. Individuals should not use it to self-diagnose a skin condition or problem.
Other risk factors include being young (teens or 20s) and having scars on areas like earlobes, shoulders, chest, or cheeks. If you have had a keloid before, you should take extra precautions.
Key Risk Factors
- Skin tone and genetics: Keloids occur most often in people with brown or Black skin. They also run in families. If a parent or sibling has had a keloid, your risk is higher.
- Age: Younger people (especially under 30) tend to develop keloids more easily than older adults.
- Wound type: Any skin injury can trigger a keloid – even a small pimple or insect bite can cause one if you’re prone. Piercings, tattoos, and surgery are common causes.
Before Piercing or Surgery
- Think it through: If you’re prone to keloids, it’s best to avoid unnecessary skin injuries. Skip body piercings, tattoos, and elective cosmetic procedures that injure the skin. Even simple wounds or ingrown hairs can trigger keloids.
- Consult your doctor: Before any surgery or medical procedure, tell your doctor (or dentist) if you or close relatives tend to get keloids. Surgeons can sometimes use techniques to minimize tension on the wound or plan post-op care accordingly. Don’t hesitate to ask about preventive measures like special dressings or early treatments.
- Test small, then pause: If you really want a piercing or tattoo, consider doing a small test spot first. For example, get a tiny tattoo or piercing and wait a few weeks. If you see thickening or abnormal scarring in the test area, remove the jewelry and let the skin heal. Acting quickly at the first sign of a bump is key.
Smart Wound Care After Piercings and Surgery
Proper care of the fresh wound is crucial to prevent keloids. Follow these steps every day until your skin heals:
- Clean gently: Wash the injured area once or twice daily with a mild soap and water. This removes germs without drying out the skin. Dermatologists specifically warn against harsh antiseptics like hydrogen peroxide or rubbing alcohol, which can actually dry and irritate the wound. Gentle care is best.
- Keep it moist: After cleaning, apply a thin layer of petroleum jelly (like Vaseline) or a medical ointment. Cover the area with a clean, sterile dressing or bandage. Moist wounds heal faster and with less scarring. Change the dressing daily, reapplying jelly each time, until the skin closes up.
- Avoid tension: Don’t let clothes, straps, or jewelry rub on the healing wound. Excess tension or stretching of a new scar can trigger keloid formation. For example, if you got an earlobe piercing, avoid heavy earrings during healing.
- Protect from the sun: UV rays can darken scars and slow healing. Keep the scar out of direct sunlight for at least a few months. Cover it with clothing or a bandage whenever possible. After the wound has healed, use a broad-spectrum sunscreen (SPF 30 or higher) on the scar. A tinted sunscreen is a good idea on darker skin to avoid a white cast.
- Use silicone products: Once the wound has fully closed and any scab is gone, start using silicone scar sheets or gel. These over-the-counter products are highly recommended for keloid prevention. Simply cut a silicone sheet to size or apply silicone gel over the scar and keep it on for most of the day. Silicone has been shown to help flatten scars and reduce redness. Dermatologists advise using it every day for about 3–6 months after healing.
Special Pressure Treatments
- Pressure earrings for earlobes: One of the most effective tricks for ear piercings is a pressure earring or pressure clip. This is a springy clip that you wear on the earlobe over the piercing site. It squeezes the scar gently to stop it from growing. At the first sign of a keloid bump on a new earlobe piercing, remove the jewelry and switch to a pressure earring. Wear the pressure earring about 12–20 hours a day for several months (4–6 months is common) to keep the keloid from getting bigger.
- Other pressure garments: For larger wounds (like on arms, legs, or chest), doctors can prescribe tight bandages or custom compression garments. These apply constant pressure to a healing scar. It’s the same idea as pressure earrings — flattening the scar. If you have a risk of keloids, ask your doctor if a pressure bandage after surgery might help.
- Early removal and treatment: If you notice a thickening scar anywhere, don’t delay. For pierced ears, that means popping out the earring at the first sign of a bump. Seek medical advice for other sites. Early treatments are much more effective when the scar is small.
Dos and Don’ts Checklist
- Do cover and moisturize the wound daily until it heals. Keep it clean with gentle washing and petroleum jelly.
- Do use silicone sheets or gel on the scar once it closes. Keep these on for several months.
- Do wear sun-protective clothing or sunscreen on the scar to avoid discoloration.
- Do listen to your body. If a healed scar feels hard or itchy, or looks raised, seek help quickly.
- Don’t apply hydrogen peroxide, alcohol, or harsh chemicals to the wound. These can irritate the healing skin.
- Don’t pick at scabs or scratch the area. Let it heal undisturbed.
- Don’t ignore early warning signs. Remove earrings or stop any procedure at the first sign of a keloid bump.
- Don’t risk new piercings, tattoos, or cosmetic surgeries without considering your keloid risk. If you do proceed, be extra cautious with aftercare.
Final Thoughts
Preventing keloids after piercings or surgery requires commitment, but it’s far easier than treating keloids once they’ve formed. Take action before problems develop, don’t wait until keloids appear.
With these practical steps discussed above, you can reduce your risk of keloids after piercings or surgery. Stay attentive to your healing skin, and act quickly at the first sign of trouble. That’s the best way to keep those scars looking smooth.
If you notice any keloids, contact Dr. Abdiaziz Dermatology Clinic promptly. Early detection and treatment can help slow its progression and improve management.
DISCLAIMER: Our articles are for general educational purposes; don’t start any skin treatment or procedure without consulting a certified dermatologist.
Dr. Abdiaziz Mohamed