Keloids can develop following the minor injuries that occur with body piercing. Since this form of physical adornment has become popular, the presence of keloidal scarring is much more prevalent. Since doctors do not understand the precise reasons why some people are more prone to developing keloids, it is impossible to predict whether one's first piercing will lead to keloid formation. Although there are some families that seem prone to forming keloids, for the most part, it's impossible to tell who will develop a keloid. One person might, for instance, develop a keloid in one earlobe after piercing and not in the other. It makes sense, however, for someone who has formed one keloid to avoid any elective surgery or cosmetic piercing of any body part.
For severe cases, the keloid can surgically excised and given x-ray treatments to the site immediately afterwards, usually the on the same day. This works in about 85% of the most severe cases. Electron beam radiation can be used, which will not go deep enough to affect internal organs. Orthovoltage radiation is more penetrating and slightly more effective. There have not been any reports of this causing any form of cancer in many years of use, but it is very expensive. Silicone pads and creams are sold over the counter for use on keloids. These do benefit hypertrophic scars but will not cure a true keloid. However, they can reduce pain, swelling and itching from a keloid. They usually take 3 months or more to work.
Skin graft or skin flap. Skin grafts or skin flaps are done after the scar tissue is removed. Skin grafts involve replacing or attaching skin to a part of the body that is missing skin. Skin grafts are performed by taking a piece of healthy skin from another area of the body (called the donor site) and attaching it to the needed area. Skin flaps are similar to skin grafts, where a part of the skin is taken from another area, but with the skin flaps, the skin that is retrieved has its own blood supply. The section of skin used includes the underlying blood vessels, fat, and muscles. Flaps may be used when the area that is missing the skin does not have a good supply of blood because of the location or because of damage to the vessels.