Keloid scars are large, raised scars that spreads beyond the size of an original wound. Sometimes it is clear what causes a keloid (earrings, acne, a cut or scrape), but they may arise without any known trauma to the skin. The most common areas for keloids to develop are the ears, mandible (jawline), shoulders and upper back. Surgical treatment is not always a good option, especially because keloids can recur and become even larger after a surgery. If surgery is performed, the chance of developing a new keloid can be minimized by using immunomodulatory creams, steroid injections (into the surgery site) or radiation therapy. Vascular laser treatments are sometimes helpful for red, hypertrophic scars, a type of scar somewhat similar to keloids.