A raised scar cannot be identified from symptoms alone
A painful, raised area may be a keloid, but pain and appearance cannot confirm that diagnosis. Another skin condition can look similar. A dermatologist can examine the lesion and may use a skin biopsy when another condition is possible.
Diagnosis comes first because a suspected keloid, another scar type, and a different skin condition do not automatically lead to the same next step.
Pain can occur with keloids
Keloids can feel uncomfortable, itchy, or painful. They may hurt while growing, remain tender, or limit movement when they cross a joint.
Those symptoms are not specific enough to diagnose a keloid or explain why a raised lesion appeared.
When to arrange assessment
Contact a dermatologist or the clinician managing isotretinoin when the pain bothers you, another new symptom appears, or the raised area limits movement.
Describe what has changed rather than trying to name the condition yourself. Do not wait for a routine acne follow-up when the pain or another symptom is now bothering you.
What a dermatology assessment may involve
A dermatologist can often identify a keloid by examining it. If another condition may be present, they may perform a skin biopsy so a small sample can be examined under a microscope.
An assessment can also account for where the raised area is located, whether it affects movement, and how it responded to any previous treatment. The clinician can then discuss a plan that fits the confirmed diagnosis and the symptom that matters most, such as pain or itch.
Coordinate assessment and any treatment
Tell the dermatologist assessing the lesion that you are taking isotretinoin, and tell the isotretinoin prescriber about the painful raised area and any proposed procedure.
Bring notes on when the area appeared, what preceded it, how it is changing, which symptom matters most, and what has already been tried. Corticosteroid injections can be used in some keloid treatment plans, but the clinicians should confirm the diagnosis and coordinate any procedure or medicine change.
Frequently asked questions
Is a painful raised scar definitely a keloid?
No. Another skin condition can look like a keloid. A dermatologist may diagnose it by examination and may use a skin biopsy if another condition is possible.
Who should assess a painful raised scar during Accutane treatment?
A dermatologist should assess the lesion, and the isotretinoin prescriber should know about it before any procedure or medicine change.
Can I get a steroid injection for a suspected keloid while taking Accutane?
Eligibility requires review by the dermatologist assessing the lesion and the clinician managing isotretinoin.
When should a painful raised scar be assessed?
Arrange assessment when the pain bothers you, another new symptom appears, or the area limits movement. Describe the symptom and how it has changed instead of trying to diagnose the lesion yourself.
Sources
- Keloid scars: Diagnosis and treatmentAmerican Academy of Dermatology
- Keloid scars: OverviewAmerican Academy of Dermatology
- Keloids: MedlinePlus Medical EncyclopediaMedlinePlus, U.S. National Library of Medicine