title: The natural history and spontaneous resolution of keloid scars.
abstract: BACKGROUND
  There is limited information available on the natural history and prognosis of keloid scars.
  
  
  OBJECTIVE
  To evaluate how keloid scars behave over time to develop prognostic information for patients.
  
  
  METHODS
  34 patients in Manchester and Barbados (average age 34 years) yielding 126 keloids completed questionnaires about their lesions.
  
  
  RESULTS
  46 keloids (37%) were described by patients as resolved, meaning they were satisfactory in appearance, not symptomatic and not requiring treatment. In each case the scar remained visible. 36 (29%) lesions resolved following treatment. Ten (8%) resolved spontaneously. The median number of years to resolution with treatment was 11.4 and to spontaneous resolution was 5, this difference was statistically significant (p < 0.05). The median number of years since resolution with treatment was 3 and since spontaneous resolution was 18, this difference was statistically significant (p < 0.0001). Seventeen lesions (13%) were resolving with treatment. 63 (50%) remained active. Overall the median number of years scars persisted was 15.
  
  
  CONCLUSIONS
  Keloids never completely disappear to leave skin with normal texture, however they can resolve (flatten and soften) so they no longer burden patients in approximately one third of cases. Scars resolving spontaneously do so early in the disease. Those that don't may resolve after many years of treatment. This data can provide prognostic information to patients, and a baseline for future therapeutic trials.
authors.affiliation: Department of Plastic Surgery, University Hospital of South Manchester, Southmoor Road, Manchester M23 9LT, UK; Queen Elizabeth Hospital, Bridgetown, Barbados.
authors.forename: Oliver J
authors.initials: OJ
authors.lastname: Smith
authors.affiliation: Department of Plastic Surgery, University Hospital of South Manchester, Southmoor Road, Manchester M23 9LT, UK; Queen Elizabeth Hospital, Bridgetown, Barbados. Electronic address: oliverjsmith@doctors.org.uk.
authors.forename: Duncan Angus
authors.initials: DA
authors.lastname: McGrouther
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007627:Keloid / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012074:Remission Induction; D012075:Remission, Spontaneous; D013997:Time Factors; D014945:Wound Healing; D055815:Young Adult
keywords: Keloid; Natural history; Prognosis; Scar; Wound healing