What is the main cause of proliferation in keloid scars?

Keloid scars are characterized by their elevated and often excessive growth beyond the original site of injury. The primary cause of this proliferation is the overproduction of collagen. During the healing process, fibroblasts, which are the cells responsible for producing collagen, become overly active. This results in an accumulation of collagen fibers, leading to the thick, raised appearance of keloids.

In normal wound healing, the body produces the necessary collagen to repair tissue, and then this production tapers off as the wound heals. In keloids, however, this regulation is disrupted, and the collagen production continues unchecked, contributing to the distinctive and sometimes painful raised scar tissue that extends beyond the boundaries of the initial wound.

Understanding the role of collagen in keloid formation is essential for both diagnosis and treatment, as therapies often aim to reduce collagen production or to break down excessive collagen in existing keloids. Other options presented, such as low melanin production, reduced skin elasticity, and increased vascularization, do not directly lead to the formation of keloid scars in the same way that collagen overproduction does.