Superficially spreading keloids are those that gradually spread and involve large areas of the skin. As keloids grow over time, they can expand and involve large areas of the skin. The rate of growth of keloids and the extent of skin involvement is keloid patients is dictated by several factors. The most important factor that determines the extent of skin involvement is the underlying genetics of the illness. Patients with severe form of keloid disorder will have several keloids that grow fast and become larger in a short period of time. This is in contrast with those who genetically have a mild form of keloid disorder and only develop one or a few small lesions in their lifetime.

The next most important factor that determines the rate of growth and shape of a keloid, is surgical intervention. Almost all patients who genetically have inherited a bad case of the disease will develop very large keloids after surgery.

Treatment of superficially spreading keloids is quite challenging. These keloids grow and spread over a wide area of the skin; and if they occur over the joints, they can often result in limitations of the range of motion of the joints. These patients are in need of a systemic form of treatment to control their disease, yet no such treatment is available as of 2020.