Neck area keloids
Neck area keloids are fairly uncommon and seen most often among individuals with black skin. Inflammation and wounding of the neck skin, either from ingrown hair or shaving blades, are perhaps the leading triggering factors of formation of these keloids in genetically susceptible individuals.
Here are some facts about neck area keloids.
- African Americans who present with neck keloids, often have keloidal lesions elsewhere in their skin. This association is not as strong among Asians / Caucasian patients, whereby in some patients, neck is the only site of keloid formation.
- Neck keloidal lesions among Asians / Caucasians is usually small in size, often nodular or linear and rarely takes on a tumoral form.
- Keloid Removal Surgery as a mean of treatment for primary neck keloids is a clear risk factor for the development of very large and massive neck keloids. Great majority of patients who have massive or very large neck keloids have previously undergone at least one prior keloid removal surgery.
- Although there are exceptions, very large and massive neck keloids are fairly race specific and almost exclusively seen among Africans /African Americans,
Neck skin is an uncommon place for the development of keloids. Indeed many keloid patients, even those with the most severe form of keloids, may never develop any keloids in the neck area. By far, the most important factor in the development of a primary keloidal lesion is the injury to skin that leads to triggering of pathological wound healing response. Although piercing of the ears is a well-recognized triggering factor for the development of primary ear keloids, no such factor has been definitively implicated in neck keloids. Neck area surgery is a known but uncommon triggering factor for formation of primary neck keloids.
Knowing that keloid is a genetic disorder of wound healing processes, it is counter-intuitive to resort to surgery as the mainstay of treatment. Surgical removal of neck 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 principle 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.
Treatment of Neck Keloids:
Treatment has to be planned very carefully. General principles of keloid treatment apply to these keloids as well. Surgery quite often results in worsening of these keloids, leading at times to loss of function and mobility of the neck. Radiation therapy should also be avoided, as it for sure will cause hypothyroidism, a new disease that the patients have to deal with for the rest of their lives. Radiation can also cause cancer of thyroid and damage to major blood vessels of the neck which may result in premature strokes and host of other long-term complications.