Newly Diagnosed Patients


Keloid Disorder (KD) is a genetic illness of wound healing process with a highly variable clinical presentation that spans from individuals with one or very few small keloidal lesions to those with numerous and very large lesions involving large portions of their skin.

Genetics of KD remains poorly understood, however, clinical observation suggests that the genetic predisposition to KD has a wide spectrum, from individuals who suffer from mild form of the disorder who in their lifetime only develop one or few slow-growing keloidal lesions, to those with very severe form of the disorder who develop numerous large and fast growing keloids; and of course, there are many others who fall somewhere in between these two extremes. Similar to most other genetic illnesses, there also exist many individuals who are simply carriers of the gene, who may never become symptomatic.

In addition to the genetics, several other factors play critical roles in clinical presentation of KD. Most importantly, there must exist an injury to the skin that would trigger abnormal wound healing response which leads to formation of keloidal lesions. Obviously, there is a wide spectrum to the severity and extent of skin injuries, ranging from very minor insults to the skin from acne, or piercing, or vaccination; to more severe forms of skin injury from surgery or burns. Besides genetics and skin injury, other important factors are age, race, gender, chronicity, therapeutic interventions as well as location of the keloidal lesions. The wide spectrum of all these factors contributes to highly variable phenotypes of KD.

By far, the most important factor in development of a primary keloidal lesion is the injury to skin that leads to triggering of pathological wound healing response. Piercing of the ears is a well-recognized triggering factor for development of primary ear keloids. Knowing that KD is a genetic disorder of wound healing processes, it is counter-intuitive to resort to surgery as the mainstay of treatment. Surgical removal of keloids is a commonly practiced intervention, not only by ear-nose-throat specialists, but also by plastic surgeons as well as general dermatologists. Surgical intervention however, defies the very basic principal in keloid formation. The injury and insult from surgery to the skin that surrounds a keloidal lesion, on its own, will undoubtedly trigger a keloidal wound healing response that often leads to formation of a new keloid.

Additional treatments in form of post-operative steroid injections, or even radiation therapy are commonly incorporated in management of every KD patient who undergoes surgery, simply to counter the fully expected recurrence after surgery. Yet despite diligent use of all available additional methods, a significant number of keloid patients will have a recurrence, which is often worse than the original keloid they had, and they undergo second, third or fourth surgery. In many unfortunate instances, keloids keep relapsing and at some point, either the surgeon, or the patient, or both, give up and the unfortunate patient ends up accepting the truth about inability of surgery to treat their keloids and see no other choice but to surrender to living with huge tumoral keloids on their ears. Almost all very bad cases of keloid that you may see, those with the most horrible keloids, are among this unfortunate group of patients.

Successful treatment of keloids requires patience and perseverance, and utilization of non-surgical methods. As keloids are chronic skin conditions, their treatment also takes time. Each keloid may require more than one method of treatment to achieve a desirable result. Choice of treatment for a given keloid will depend on its location, size and thickness and also, all prior treatments.


    KRF Clinical Practice Guidelines for Treatment of Keloids:

    (January 11, 2019) KRF is proud to announce publication of several Keloid Treatment Guidelines. Authoring and production of these Guidelines has been a time-consuming task, yet one that has been long waited for. These Guidelines reflect the most up to date approach to treatment of keloids. We hope that the Guideline allow for establishment of standards in treating keloid patients across the globe. KRF Practice Guidelines.

    3rd International Keloid Symposium:

    (July 15, 2018) KRF is proud to announce that the 2nd was successfully held on June 7-8, 2018 in Rome, Italy with attendees from 22 different countries. During this meeting, KRF was invited to host the 3rd International Keloid Symposium in Beijing. Since the Rome meeting, the organizing committee has worked hard to make this a reality. We are now pleased to announce that our next meeting, the 3rd International Keloid Symposium, which will be a three day meeting will be held in Beijing, China on April 19-21 at the Lecture Hall of the Peking Union Medical College Hospital. Click on the image below to be directed to the symposium website.

    2nd International Keloid Symposium:

    (January 18, 2018) KRF is proudly announcing that the 2nd will be held on June 7-8, 2018 in Rome, Italy. Click on the image below to be directed to the symposium website.

    Notice of 501 (C)(3) Status:

    (February 1, 2017) Keloid Research Foundation has been determined by the US Internal Revenue Service (IRS) to be exempt from federal income tax under Internal Revenue Code (IRC) Section 501(C)(3). Donors can deduct contributions they make to KRF under IRC Section 170. Click here to view the 501(C)(3) Exemption Document.

    Journal of Keloid Research:

    (December 3, 2016)KRF is proud to announce establishment of Keloid Research, an open access scientific publication of the Keloid Research Foundation. Until now, keloid manuscripts have been published in a variety of journals. Our goal is to create a centralized publishing platform for all researchers who are passionate about this disorder, so that relevant clinical and laboratory research can be published in one place and under one umbrella. The journal is aiming to provide an international forum for the publication of original work, describing basic science, translational and clinical investigations in keloid disorder.

    Keloid Staging System:

    (August 19, 2016) In his most recent publication, "Neck Keloids: evaluation of risk factors and recommendation for keloid staging system" Dr. Tirgan has designed a staging system that allows for proper categorization and grouping of keloid patients into various stages.

    To assess each keloid patient properly, to better understand the natural history of this disorder, and to be able to compare future keloid study results among various patients groups, we clearly need a staging system that can allow us to describe the severity keloid disorder based on the size, location and/or extent of the keloidal lesions; as well as history of surgery or radiation therapy, and perhaps other factors that are currently unknown to us. Please click HERE to read more.