Mr. Onur Gilleard
Qualifications & Experience
Mr Onur Gilleard is a distinguished consultant plastic surgeon on the GMC specialist register. He previously held an NHS consultant post at St Bartholomew’s Hospital in London, specialising in skin cancer and microsurgical reconstruction. In 2021, Mr Gilleard transitioned from the NHS to dedicate himself fully to private practice, allowing him to focus exclusively on providing personalised, high-quality care to his patients. He is recognised as an expert in laser treatments, having conducted research and developed advanced treatment protocols using cutting-edge laser technology to optimise both clinical outcomes and cosmetic results.
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A keloid scar forms when the skin over-produces collagen during healing, so the scar grows beyond the original wound instead of settling flat. They’re driven largely by genetics and skin type — more common in darker skin tones and where there’s a family history — and triggered by anything that breaks the skin: piercings, acne, surgery, burns, even small cuts. You can’t always prevent them, but if you’re prone, you can reduce the risk. Here’s what causes keloids and how to lower your chances.
Why Keloids Form
When skin heals, it lays down collagen to close the wound and then normally stops. In a keloid, that “stop” signal fails — the healing process keeps producing collagen, and the scar tissue expands past the edges of the original injury, becoming raised, firm, often shiny, and sometimes itchy or tender. This is what separates a keloid from a hypertrophic scar, which is raised but stays within the wound’s borders and tends to improve over time. Keloids rarely settle on their own. The full treatment picture is in our cornerstone keloid removal guide.
Who’s Most at Risk
- Skin tone: keloids are considerably more common in people with darker skin (Black, East Asian, South Asian and Hispanic backgrounds).
- Family history: a strong genetic component — if close relatives get keloids, your risk is higher.
- Age: they most often first appear between the teens and thirties.
- Keloid-prone sites: earlobes, chest (sternum), shoulders, upper back and jawline are the classic locations.
Common Triggers
Almost anything that injures the skin can set off a keloid in a susceptible person: ear and body piercings (a very common cause of earlobe keloids), acne and folliculitis, surgical incisions, burns, tattoos, vaccinations and even minor scratches. Occasionally a keloid appears with no obvious injury at all. Knowing you’re prone is useful information before any elective procedure that breaks the skin.
How to Reduce the Risk
You can’t change your genetics, but if you know you’re keloid-prone you can stack the odds in your favour:
- Avoid non-essential skin trauma — think carefully about piercings and elective procedures in keloid-prone areas.
- Treat wounds well — keep healing skin clean, protected and out of strong sun.
- Use silicone early — silicone gel or sheeting on a healing wound has good evidence for reducing raised scarring.
- Flag your history — tell any surgeon you’re keloid-prone, so they can plan incisions and consider preventive steroid or silicone.
- Act early — a small, new keloid is easier to manage than a large established one.
If a keloid is already forming, early assessment and steroid injection can flatten it before it grows.
Frequently Asked Questions
- What actually causes a keloid?
- An over-active healing response that keeps producing collagen after a skin injury, so the scar grows beyond the original wound. It’s largely down to genetics and skin type, triggered by anything that breaks the skin — piercings, acne, surgery, burns or minor cuts.
- Can keloids be prevented?
- Not always, but if you’re prone you can reduce the risk: avoid unnecessary piercings and skin trauma in keloid-prone areas, protect and care for healing wounds, use silicone early, and tell any surgeon about your history so they can take precautions.
- Is a keloid the same as a raised (hypertrophic) scar?
- No. Both are raised, but a hypertrophic scar stays within the original wound’s borders and often fades over time, whereas a keloid grows beyond the wound and rarely settles without treatment.
- If keloids run in my family, will I definitely get them?
- Not necessarily, but your risk is higher. A family history and darker skin tone both increase susceptibility, which is worth bearing in mind before elective procedures that break the skin.
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