Just like in construction, sometimes things get out of control and are mismanaged. Atypical molecular changes during normal wound healing phases cause keloid formation For example, during keloid formation, collagen synthesis is twenty times greater than in normal skin. Growth factors involved in healing skin wounds are also overproduced, and contribute to the over-expression of collagen fibers since keloidal fibroblast cells are hypersensitive to the growth factors. Conversely, in the dysfunctional keloid healing process the body does not produce enough of the enzymes needed to break down the original clot and scaffolding that the final tissue is built on. Keloidal skin cells also have unregulated cell cycles where the rates of normal cell death (apoptosis) are much lower than in normal cells, contributing to the excess tissue that accumulates in keloids.5
There are a number of risk factors that can make one person more likely to develop a keloid than another. In addition, certain areas of the body are more prone to keloids. Ear piercing, a common cultural practice, is frequently an injury that prompts a keloid to develop. However, there are measure that can be taken to help prevent keloids.