Keloids

What it is

A keloid is a firm, raised, shiny scar that grows beyond the edges of the original wound. Keloids commonly form on earlobes, the chest, shoulders, jaw and back after piercings, acne, surgery or minor injuries. They may itch or hurt.

How it works

A keloid forms when the healing process doesn't switch off. Fibroblasts keep producing collagen long after the wound has closed, so the scar grows beyond the original injury. Genetics play a large role, and darker skin is more prone.

Why it matters on darker skin

Keloids are much more common in people of African descent and often run in families. Some people form them after very minor skin injury.

Causes and triggers

Ear piercing, acne on the chest and jaw, surgery, burns, vaccinations, shaving bumps and tribal or decorative marks. Areas under tension — chest, shoulders, ear lobes — are most prone.

What helps — and why it works

Prevention is key if you are prone: avoid unnecessary piercings, tattoos and cosmetic surgery, and treat acne early. A doctor can offer treatments such as injections into the scar, silicone sheets or gels, and pressure earrings after earlobe keloid removal. Combined treatments work best. Early treatment by a doctor: steroid injections flatten young keloids best. Expected timeline: improvement over several sessions spaced weeks apart. Silicone gel or sheets: hydrate the scar and reduce collagen overgrowth. Expected timeline: use for 2–3 months. Pressure for ear keloids after removal: reduces recurrence. Expected timeline: months.

What to avoid and why

Do not cut, tie off or burn a keloid at home. Surgery alone often leads to a larger keloid returning, so it should be combined with other treatment by a specialist.

Common mistakes

• Cutting a keloid off without follow-up treatment — it often returns larger.
• Further piercings if you know you form keloids.
• Applying corrosive home remedies.

Building a routine that lasts

Most skin problems improve with a short routine used every day rather than many products used occasionally. A practical base is a gentle cleanser, a fragrance-free moisturiser and a broad-spectrum sunscreen in the morning, with one targeted treatment at night. Introduce one new product at a time and give it two weeks before adding another, so that if your skin reacts you know the cause. Patch-test on the inner arm or behind the ear for a few days first. Skin renews itself roughly every four to six weeks, so most treatments need two to three cycles — eight to twelve weeks — before you can judge them fairly. Photographs taken in the same light every four weeks are more reliable than memory. In the Nigerian climate, heat, humidity and harmattan all change what your skin needs: lighter gels in the humid season and richer creams in dry months are both reasonable. If a product stings for more than a few minutes, causes swelling, or leaves new dark patches, stop it. Buy from registered pharmacies or official stockists, and use the Authenticity Check if you are unsure whether a product is genuine.

Reading labels and choosing products

On the label, look first for the active ingredient and whether the product is fragrance-free and non-comedogenic. Ingredients are listed in order of amount, so an active at the end of a long list may be present only in a small quantity. Be wary of products that promise results in days, that list no ingredients, or whose label is a sticker or handwritten. Words such as 'natural', 'herbal', 'organic' and 'dermatologist-inspired' are marketing terms, not safety standards. Hydroquinone, mercury compounds (sometimes listed as calomel or mercurous chloride) and strong steroids such as clobetasol do not belong in an over-the-counter cosmetic. A real NAFDAC registration number should be printed on the pack and should match the product on the official Greenbook register. Price is not proof: counterfeiters copy expensive brands. When in doubt, ask a pharmacist, keep your receipt, and use Melanin & Me's Authenticity Check and barcode scanner as a first screen.

Questions to ask your doctor or pharmacist

Useful questions include: What do you think is causing this? Is it likely to come back, and how can I prevent it? Which products should I stop? How long before I should expect improvement, and when should I come back if it isn't better? Are there side effects to watch for? Is this treatment safe if I am pregnant, breastfeeding or for my child? Writing your questions down, bringing your products (or photos of their labels) and taking dated photos of the problem make an appointment much more useful.