Specific patient factors that increase the likelihood of keloid formation include a genetic predisposition, darker skin phototypes, younger age, and a history of previous keloid or hypertrophic scar formation. Individuals of African, Asian, or Hispanic descent are more prone to keloid development due to inherent skin characteristics and fibroproliferative responses NICE CKS Ogawa 2017. Additionally, keloids are more common in younger patients, particularly those between 10 and 30 years of age, possibly related to more active skin repair mechanisms during this period NICE CKS Frech et al. 2023. A personal or family history of keloids significantly raises the risk, indicating a genetic or familial component to susceptibility NICE CKS Ogawa 2017. Furthermore, chronic inflammation in the reticular dermis is a key pathological driver of keloid formation, suggesting that any factor increasing dermal inflammation or skin injury severity may elevate risk Ogawa 2017. Recent literature also highlights that patients undergoing skin procedures while on isotretinoin may have altered scar outcomes, although the direct impact on keloid risk requires further clarification Latifaltojar et al. 2025.
In clinical consultations, awareness of these factors should guide risk assessment and patient counselling regarding wound care and scar management.
Key References
- CKS - Leg ulcer - venous
- NG211 - Rehabilitation after traumatic injury
- NG198 - Acne vulgaris: management
- CKS - Acne vulgaris
- CKS - Pressure ulcers
- (Ogawa, 2017): Keloid and Hypertrophic Scars Are the Result of Chronic Inflammation in the Reticular Dermis.
- (Frech et al., 2023): Hypertrophic Scars and Keloids: Advances in Treatment and Review of Established Therapies.
- (Latifaltojar et al., 2025): Keloid Formation and Any Skin Complications in Patients Treated With Isotretinoin and Undergone Any Skin-Related Procedures.