Keloids: An old problem still searching for a solution

Abstract

An increasing number of patients with keloids present to the plastic surgeon and dermatologist practising in a predominantly black population such as ours. The black and Asian races are more affected than Caucasians. Apart from the aesthetic, psychological and social consequences, keloids may be symptomatic, causing severe itching, pain and tenderness, restriction of chest movement (presternal keloid), sleep disturbances, infection and suppuration. The multiplicity of treatment modalities suggests that there is no satisfactory therapy, with frustration to both the patients and physician. This paper reviews the current state of knowledge of the pathophysiology and the various approaches to treatment. Research efforts are still ongoing to discover more effective therapeutic intervention.