Keloids are nodular, often lobulated, firm to hard but movable, non-encapsulated masses of hyperplastic scar tissue. Africans are particularly susceptible to keloids. The tribal scar pattern following scarification is based on this property. Keloids occur in all types of conditions, for example after burns, cauterisation, vaccinations, on in-growing beard hair, folliculitis or even spontaneously. Keloids are raised and sharply delineated. The overlying skin is reddish and shiny. The lesion can be itchy or painless and the dimensions can be unexpectedly large. Keloids can develop later on, up to years after the initial trauma. Treatment is difficult. Complete excision is followed by recurrence in 70% of cases. Excision within the edges of the lesion is recommended, but the result is aesthetically unsatisfactory. Corticosteroids have no effect on the fixed lesions, but can prevent their recurrence by injections localised around the site of the original lesion if started 3 weeks after surgey and repeated weekly for the following 8-12 weeks.

Keloids are to be differentiated from lobomycosis.