What Are Keloids?
Keloids are raised, irregular scars that extend beyond the site of an injury. They are composed of excessive amounts of collagen – the protein that helps heal wounds – deposited in an disorganized fashion. Keloids tend to become symptomatic and dysfunctional, itching and restricting movement. They most often affect earlobes, shoulders, upper back and chest.
Anyone can develop a keloid, but risk factors include:
- Family history of keloid scarring
- Younger age (under 30)
- Having darker skin (Fitzpatrick skin types IV-VI)
While all wounds carry some risk of keloid formation in susceptible individuals, certain events have a higher association:
- Piercings
- Burns
- Accidents
- Surgery
Keloids differ from hypertrophic scars – which stay within wound borders – in their tendency to spread beyond the original injury site and invade surrounding tissues. They also become symptomatic faster and can persist for years.
What Is Microblading?
Microblading is a semi-permanent cosmetic tattooing technique that implants pigment into the dermis layer of the skin to mimic the appearance of hair strokes for fuller brows. During the procedure, a tool with ultra-fine needles deposits pigment under the skin in the shape of brow hairs. The pigment settles around tissue and capillaries, resulting in natural-looking strokes that can last between 12 to 24 months. As the skin heals, the pigment fuses with the dermis. However, in very rare cases, individuals prone to keloid scarring may develop raised, symptomatic keloid growths along the pigment strokes following the procedure. Still, most people are at no increased risk of keloids due to microblading.
Can Microblading Trigger Keloids?
Since microblading involves creating tiny wounds by implanting pigment into the dermis, there is a theoretical risk it could trigger keloid growth in susceptible individuals. However, only a very small percentage of microblading clients actually develop keloids afterward.
There is a small, but real, chance that microblading may cause keloid formation, but only in those individuals who are prone to developing them, to begin with. If you have or are prone to developing raised scars (keloid) in the procedure area, you will be at risk of keloid formation from a tattoo.
Risk factors: Research suggests people who have a tendency to develop keloid scars from other types of wounds – like ear piercing or surgery – are also at higher risk of keloid formation following microblading. Factors that make someone prone to keloid scarring in general, like family history and skin type, can increase their risk after the procedure.
No increased risk: Most experts agree microblading itself does not directly cause keloid formation in the majority of clients. Any keloids that do occur are likely due to a person’s preexisting risk factors and propensity for abnormal wound healing, rather than something intrinsic to the procedure. Even in at-risk groups, only a minority of individuals will develop keloids post-microblading.
Incidence rate: The actual percentage of microblading clients estimated to experience keloid growth afterward ranges from 0.5% to 3%, depending on factors like ethnic background. For example, up to 16% of people with African ancestry are prone to keloid scarring in general, so their risk is higher following microblading.
Avoidance: Candidates known to be prone to keloid formation from other wounds are typically advised to avoid microblading altogether or proceed with extreme caution. Technicians may also recommend techniques to minimize the risk, like using finer needles to create shallower wounds or implanting pigment more superficially.
In summary, while microblading involves the very slight trauma needed to potentially trigger keloids in susceptible clients, research shows true keloid formation after the procedure is actually quite uncommon. Most people experience normal, non-symptomatic scarring and healing following microblading with no complications. However, the risk is significantly higher in those with established risk factors for abnormal scar development. Avoidance is advised for these high-risk groups whenever possible.
Symptoms Of Keloid After Microblading
1. Raised bumps
Several weeks to months after microblading, susceptible individuals may develop raised, tender bumps that follow the shape of the pigment strokes. These bumps are composed of excess collagen deposited by the body during the abnormal wound healing process. They typically feel firm and nodular to the touch.
2. Itching
Keloids often produce an itchy, irritating sensation due to the proliferation of nerve endings within the scar tissue. Antihistamines may help relieve itchiness temporarily.
3. Change in color
Keloids typically appear darker red initially before transitioning to a purple-pink color. They can also be flesh-colored, depending on the individual’s skin tone.
4. Spreading
Untreated keloids have a tendency to invade surrounding tissues and gradually become larger over time. They can spread beyond the initial pigment stroke, distorting the treated area. Typically, keloids will stabilize and stop growing within 2 years.
5. Loss of pigment
The growth of a keloid scar can distort microblading pigment strokes and cause some ink to become dislodged from the dermis, resulting in fading in localized areas. This leads to an uneven result.
6. Difficulty healing
Keloids are resistant to typical scar treatments and often do not respond well to creams or ointments. They also recur after excision at a high rate, requiring specialized approaches.
7. Pain
While keloids are typically painless initially, they can become painful if they interfere with movement or pinch surrounding nerves and tissues.
8. Delayed onset
Keloid symptoms usually occur 2-4 weeks after microblading. However, in some cases, keloids may not arise until months later as the skin continues to heal and remodel scar tissue. This makes them difficult to identify as resulting from the procedure.
What Should You Do If You Develop A Keloid Scar After Microblading?
- Discontinue all aftercare products and avoid irritating the brows. Cover the area to protect it from further trauma that could worsen the keloid.
- See your dermatologist or a scar expert as soon as possible. They can properly diagnose the keloid and determine the best treatment approach. Do not attempt to treat it yourself.
- Your doctor may prescribe corticosteroid injections directly into the keloid. This is the first-line treatment and has a 60-80% success rate.
- If injections fail, other options include cryotherapy (freezing), silicone gel sheeting, compression garments, laser therapies and 5-fluorouracil (5-FU) injections. These often require multiple treatments over time.
- As a last resort, surgical excision may be performed to remove the keloid. However, the risk of recurrence after surgery is 80-90%, so additional therapies are usually needed post-operatively.
- Consider revision by your microblading technician once the keloid has been successfully treated and stabilized. They can revise the pigment strokes to restore a more natural brow shape.
- Discuss preventative measures for the other brow to reduce the risk of a second keloid, like using different pigments or needles. Your doctor may also prescribe medications to help control excessive scarring.
- Be patient – keloid treatment can be a long process requiring multiple modalities and visits. Set realistic goals and expectations with your doctor to maintain optimism. With time and proper care, the scar can often be improved.
The most important steps are seeing a specialist immediately and strictly adhering to their treatment plan to achieve the best outcome with the least hassle. With proper medical management, microblading keloids have a good chance of improving and stability over time.
While rare, keloid formation remains a potential risk after microblading, especially for individuals prone to abnormal scarring. However, most people experience normal healing without complications. Any keloid symptoms that do arise following the procedure require prompt treatment by a specialist to stop progression and achieve the best outcome. With medical management and possible revision, microblading keloids can often be improved and stabilized long-term.
FAQs
1. What increases keloid risk after microblading?
A history of keloid scarring from other wounds, family history of keloid tendency and certain ethnic backgrounds that are predisposed can elevate risk following microblading.
2. How can keloids be prevented?
For high-risk individuals, techniques that create shallower wounds and implant less pigment can help. Steroid injections preemptively may reduce the chance of keloids.
3. How are keloids treated?
First-line is corticosteroid injections directly into the scar. Other options include 5-FU injections, laser treatments, compression garments and surgical excision with postoperative measures.
4. Can keloid symptoms appear later?
Yes, while most keloid symptoms emerge within weeks after injury, in some cases they may take months to form as skin continues to heal and remodel scar tissue. This delays diagnosis and treatment.