Pubic area is another particular part of the body that is prone to keloid formation, obviously in those who are genetically prone to keloid disorder. Ingrown hair and lower abdominal and pubic area surgery, commonly due to C-Section are the two most important triggering factors for pubic keloids. These keloids are more common among African American women and somewhat less common in men.
The clinical presentation of pubic keloids is somewhat variable. As depicted in following images, pubic keloids start as a small papule that can grow over time. Among Asian/Caucasian women, pubic keloid remain small and very limited in number. Among African/African American women however, the primary pubic keloids can become tumoral and expand in size. The worse cases of pubic keloids are seen with women who have recurrent keloids after surgical attempt to remove a primary pubic keloid.
Pubic keloids vary in size and shape, as such the treatment has to be customized for each patient. Surgery and Radiation therapy must be avoided in treating pubic keloids, as they both carry a very high risk of worse outcome. All pubic keloids have to be treated with non-surgical means. Cryotherapy is the best treatment for bulky pubic keloids. Intra-lesional steroid injections are safest treatment for very small pubic keloids in Asian and Caucasian patients.