Understanding Keloids in Hawaii: Causes, Risks, and Effective Treatments
- Hawaiian Islands Dermatology Website
- 2 days ago
- 4 min read
You might have noticed a small bump that started after a piercing or a bout of acne. At first, it was barely noticeable. Over time, it grew larger, extending beyond the original spot. This raised, firm scar is likely a keloid. For many people living in Hawaii, keloids are a common concern, especially when they appear in visible places like earlobes or the chest. Understanding why keloids form, how Hawaii’s unique environment affects them, and what treatments are available can help you manage or even prevent these stubborn scars.
What Keloids Are
Keloids are raised scars that grow beyond the boundaries of the original wound. Unlike typical scars that fade and flatten over time, keloids continue to expand. They form because your skin produces excess collagen during the healing process. This overproduction causes the scar tissue to bulge out, creating a thick, firm bump.
You may notice that keloids itch or hurt, especially as they grow. This growth can take months, sometimes even years. The texture is often shiny and smooth, and the color can range from pink to dark brown, depending on your skin tone. Keloids are not harmful in a medical sense, but they can cause discomfort and affect your confidence.
Where Keloids Form Most
Certain areas of the body are more prone to keloid formation. In Hawaii, common spots include:
Earlobes: Piercings are a frequent cause. The skin here is thin and prone to tension, which can encourage keloid growth.
Jawline and chest: Acne scars in these areas often develop into keloids, especially if the acne was severe or picked at.
Surgical sites: Any surgery or injury can leave a scar that turns into a keloid, particularly if the wound was under tension or took longer to heal.
Skin under tension: Areas where the skin stretches or moves a lot, such as the shoulders or back, may develop keloids more easily.
Knowing where keloids tend to form can help you watch for early signs and seek treatment before they grow larger.
Why Hawaii’s Climate Matters
Hawaii’s warm, humid climate plays a significant role in how wounds heal and scars develop. High humidity slows down the healing process by keeping the skin moist, which can encourage excess collagen production. This means wounds may stay open or inflamed longer, increasing the chance of keloid formation.
Sun exposure is another factor. Ultraviolet (UV) rays can deepen the color of fresh scars, making them more noticeable. Since many people in Hawaii spend a lot of time outdoors, new scars are often exposed to the sun without proper protection. This exposure can worsen the appearance of keloids.
Additionally, an active outdoor lifestyle means more chances for cuts, scrapes, and injuries. Even small wounds can turn into keloids if they don’t heal properly in this environment.
Who’s at Higher Risk
Keloids can affect anyone, but some people are more likely to develop them. Family history plays a role: if your parents or siblings have keloids, your chances increase. Ancestry also matters. People with darker skin tones, including many Native Hawaiians and Pacific Islanders, tend to form keloids more often.
Keloids are most common in patients between 10 and 30 years old. This age range corresponds with the skin’s active healing and collagen production phases. If you notice raised scars during these years, it’s important to address them early.
Your skin’s tendency to scar also influences keloid risk. Some people naturally produce more collagen during healing, which can lead to these raised scars. This is not something you can control, but knowing your risk can help you take preventive steps.
Treatment Options
If you have a keloid, several treatment options can help reduce its size, discomfort, and appearance. Doug Williams, MPAS, PA-C, at Hawaiian Islands Dermatology in Kailua, Oahu, offers a range of treatments tailored to your needs.
Cortisone injections: These are the first-line treatment. Cortisone helps reduce inflammation and collagen production, shrinking the keloid over time. Multiple sessions may be needed.
Silicone sheets or gel: Applying silicone products daily can soften and flatten keloids. These are especially useful for scars that are still healing.
Pressure earrings: For keloids on earlobes, pressure earrings apply constant gentle pressure, which can prevent growth or reduce size.
Laser therapy: Laser treatments can improve the texture and color of keloids, making them less noticeable.
Surgery and radiation: In severe cases, surgical removal combined with radiation therapy may be considered. This approach requires careful planning to avoid recurrence.
Each treatment has its pros and cons. Your provider will help you choose the best option based on your scar’s size, location, and your skin type.
Prevention and What to Avoid
Preventing keloids is easier than treating them once they grow large. Here are some practical tips:
Start using silicone sheets within two weeks after your wound closes. This helps control collagen production early.
Apply SPF sunscreen on new scars to protect them from UV damage.
Do not pick or scratch at scabs or healing skin. This can trigger keloid formation.
Avoid unproven home remedies like apple cider vinegar or onion extracts. These can irritate your skin and worsen scars.
Taking care of your skin during healing is the best way to avoid keloids or keep them small.
When to See a Provider
If you notice a raised scar growing beyond the original wound, it’s time to see a specialist. Doug Williams, MPAS, PA-C, at Hawaiian Islands Dermatology in Kailua, Oahu, has experience treating keloids with personalized care.
You can visit the clinic in person or use telehealth services if you live on the Big Island, Maui, Kauai, Molokai, or Lanai. Hawaiian Islands Dermatology accepts Quest and Medicaid insurance, making treatment accessible.
Early consultation improves your chances of managing keloids effectively. Don’t wait until the scar becomes large or painful.
A Local Note
In Hawaii, small scars often become big ones if left untreated. The combination of humid weather, sun exposure, and active lifestyles means your skin faces unique challenges. Early treatment is the whole game. Addressing keloids when they are small can prevent discomfort and reduce their impact on your appearance.
If you have a raised scar from a piercing, acne, or surgery, take action now. The right care can make a difference.
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