predisposing factors

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The following factors predispose to keloids:

  • race:
    • there is a linear relationship between the amount of skin pigmentation and the likelihood of keloid scars; overall keloids are 5-15 times more common in darker-skinned races than in white, caucasian skin
    • keloids are most common in Afrocaribbean and Asian skin
    • early studies indicated that more common in those of Chinese descent compared to those with an Indian or Malaysian background
  • age:
    • keloids most commonly occur between 10-40 years of age
    • they only rarely arise de novo elderly subjects
  • site; in order of decreasing frequency, keloids occur most commonly at the:
    • sternum
    • shoulder
    • neck
    • face
    • extensor surface of limbs
    • truncal sites other than sternum
  • gender:
    • contradictory studies have suggested the highest prevalence in young females, particularly when there are keloids at multiple sites and there is a strong family history(1); this may reflect the higher rate of pierced ears in this group
    • in other age groups, there is no gender bias
  • genetic:
    • as suggested by the racial predisposition
    • associated with a number of genetic loci


(1) Bayat A, Arscott G et al. Br J Plast Surg (2005); 58(1): 28-37.

Last reviewed 01/2018