As keloids grow in size, they can develop secondary complications such as bleeding and infections. A sudden onset appearance of pain in a keloid is most often due to an infection. An infected keloid will need to be attended to urgently. Such infections cause pain, discomfort as well as risk of causing a systemic and rarely blood stream infections. An infected keloid is tender, painful and warmer than the surrounding normal skin. A course of oral antibiotics can usually resolve this complication.
Once a keloid becomes infected, it runs the risk of re-infection. Quite often, in patients who have multiple keloids, it is a particular keloid that gets infected all the time. The image below depicts a keloid that is acutely infected with purulent material oozing from the edges. Antibiotics alone are not enough for such a keloid. The necrotic and infectious material has to be drained to allow antibiotics to work.