Keloids are not filled with a specific “substance” like a cyst or a fluid-filled sac; rather, they are made up of excessive collagen. They are a type of fibrous scar tissue that forms after the skin has been injured or wounded. Instead of the scar tissue remodeling and flattening over time like a typical scar, keloids grow beyond the boundary of the original wound and can continue to expand, forming a thick, raised, and sometimes rubbery or hard bump on the skin-Keloid Treatment in Dubai.

Understanding Keloid Composition

To better understand what keloids are “filled” with, it helps to look at their structural composition:

1. Collagen

The primary component of a keloid is collagen, a fibrous protein that is the body’s natural building block for skin, tendons, and ligaments. When a wound heals, collagen is produced by fibroblast cells to repair the tissue.
In the case of a keloid, the body produces too much collagen during the healing process. This excessive collagen accumulates at the site of the injury, causing the scar tissue to grow beyond the boundaries of the original wound.
Over time, the collagen fibers in a keloid can form thick, disorganized, and tightly packed bundles, giving the keloid its characteristic raised, firm texture. This “overproduction” of collagen is the primary cause of the keloid’s appearance.

2. Fibroblasts

Fibroblasts are the cells responsible for producing collagen and other extracellular matrix components. In a keloid, there is an overabundance of fibroblasts at the wound site.
These fibroblasts work excessively to produce collagen in an attempt to repair the skin, but unlike in normal scar formation, the process goes on for too long, causing the keloid to expand and become raised.

3. Extracellular Matrix (ECM)

The extracellular matrix (ECM) is the network of proteins and other molecules that surround and support cells. In keloids, the ECM becomes altered, and an excessive amount of collagen and other components like elastin, glycosaminoglycans (GAGs), and fibronectin accumulate.
The changes in the ECM contribute to the keloid’s abnormal structure and appearance. The matrix of a keloid is denser and more fibrous than normal skin, which causes the scar tissue to become rigid, raised, and often itchy.

4. Blood Vessels

Keloids often have an increased number of blood vessels compared to regular scars, which is why keloids can appear reddish or purple in color, especially in the early stages.
These new blood vessels are part of the body’s attempt to heal the damaged skin, but they contribute to the blood flow and vascularity of the keloid. Over time, however, the blood vessels may decrease, and the keloid may become paler and firmer.

What Keloids Are Not “Filled” With

It’s important to note that keloids do not contain pus, liquid, or any other type of fluid like some cysts or abscesses. They are purely fibrous structures composed primarily of collagen and fibroblasts. There is no fluid accumulation within the keloid (except in cases of severe irritation or infection, which are not typical for keloids themselves).

Why Do Keloids Form?

Keloids form as a result of an abnormal wound-healing process. While the exact cause is not fully understood, several factors can contribute to the development of keloids:

Genetics: People with a family history of keloids are more likely to develop them, indicating a genetic predisposition to overproduction of collagen.
Skin type: Darker skin types are more prone to keloid formation, though keloids can occur in people of all ethnic backgrounds.
Injury or Trauma: Any skin injury—whether from cuts, piercings, surgery, acne, or burns—can trigger keloid formation. The more aggressive the injury or irritation, the more likely a keloid will develop.
Hormones: Hormonal changes, especially those during adolescence and pregnancy, can increase the likelihood of keloid formation.
Inflammation: Keloids are more likely to form in areas where inflammation has been prolonged or severe.

How Keloids Differ from Normal Scars

While normal scars also consist of collagen and fibrous tissue, they do not grow beyond the original wound site. Normal scar tissue is often flat or slightly raised and may fade or flatten over time. In contrast, keloids are larger, raised, and often grow beyond the boundaries of the original injury. Keloids can also become red, purple, or darker than the surrounding skin.

Conclusion

In summary, keloids are not filled with any fluid or substance like a cyst but are made up of excess collagen and fibroblasts. The excess collagen production results from an abnormal healing process, leading to thick, raised, and sometimes large scars that grow beyond the site of injury. They may also contain disorganized extracellular matrix material and an increased number of blood vessels. While the precise cause of keloid formation is not fully understood, it is clear that keloids involve the overproduction of scar tissue rather than a “filling” of fluid or pus. Treatment options aim to reduce the production of collagen and prevent the keloid from growing larger.