Articles
Early Access
https://doi.org/10.4081/dr.2025.10396

Epidemiology of keloids among university students in Uganda

Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Published: 26 November 2025
246
Views
84
Downloads
Keloids, hypertrophic scars, Africa, Sub-Saharan Africa, epidemiology, prevalence

Authors

Ronald Mbiine
mbiineron@gmail.com
Department of Surgery, College of Health Sciences, Makerere University, Kampala, Uganda.
Misaki Wayengera
Department of Immunology and Molecular Biology, College of Health Sciences, Makerere University, Kampala, Uganda.
Noah Kiwanuka
School of Public Health, Makerere University, Kampala, Uganda.
Ian Munabi
Department of Human Anatomy, College of Health Sciences, Makerere University, Kampala, Uganda.
Haruna Muwonge
Department of Physiology, College of Health Sciences, Makerere University, Kampala, Uganda.
Cephas Nakanwagi
Mulago National Referral Hospital, Kampala, Uganda.
Moses Joloba
School of Biomedical Sciences, Makerere University, Kampala, Uganda.
Moses Galukande
Department of Surgery, College of Health Sciences, Makerere University, Kampala, Uganda.

Keloids are benign yet persistent fibroproliferative disorders characterized by raised, irregular scars that extend beyond the original wound margins. In addition to causing disfiguring scars, pain, and restricted mobility, keloids significantly impact psychosocial well-being, often leading to emotional distress and socioeconomic challenges for the affected individuals. Although keloids are recognized as being most prevalent among individuals of African descent, there remains a paucity of epidemiological data on their prevalence in African populations. This gap in knowledge has contributed to the limited prioritization of keloid management in healthcare policies and treatment strategies. This study aimed to determine the prevalence of keloids among university students in Uganda and analyze the demographic and patient-related factors associated with keloid development, with particular focus on age, sex, ethnicity, family history, blood group, and skin complexion. A descriptive, cross-sectional study was conducted among 502 university students at Makerere University in Kampala, Uganda. Data were collected using structured questionnaires and direct visual inspection of scars by trained research assistants. Statistical analyses were performed to determine the prevalence and evaluate the associations between keloids and participant characteristics. The prevalence of keloids among study participants was 4.18%, while hypertrophic scars were observed in 20.32%. A positive family history was identified as the strongest association with keloid development. No significant associations were found between keloid formation and ethnicity, blood group, or skin complexion. The study provides population-based prevalence data on keloids and emphasizes the role of genetic predisposition in keloid formation. The findings underscore the need for increased awareness, identification of at-risk populations, and strategized preventive interventions for keloid development.

Downloads

Download data is not yet available.

Citations

Crossref
Scopus
Google Scholar
Europe PMC
1. Dand N, Ung CY, Saklatvala JR, et al. GWAS Meta-Analysis Identifies Susceptibility Loci for Keloids and Hypertrophic Scarring in Europeans. J Invest Dermatol 2025;145:1538-40.e8. DOI: https://doi.org/10.1016/j.jid.2024.12.011
2. Jones LR, Young W, Divine G, et al. Genome-Wide Scan for Methylation Profiles in Keloids. Dis Markers 2015;2015:943176. DOI: https://doi.org/10.1155/2015/943176
3. Marneros AG, Norris JEC, Watanabe S, et al. Genome Scans Provide Evidence for Keloid Susceptibility Loci on Chromosomes 2q23 and 7p11. J Invest Dermatol 2004;122:1126-32. DOI: https://doi.org/10.1111/j.0022-202X.2004.22327.x
4. Greene C, Hampton G, Jarvik G, et al. 47 Cross-ancestry GWAS meta-analysis of keloids discovers novel susceptibility loci in diverse populations. J Clin Transl Sci 2024;8:13. DOI: https://doi.org/10.1017/cts.2024.58
5. Feng G, Sun H, Piao M. FBXL6 is dysregulated in keloids and promotes keloid fibroblast growth by inducing c-Myc expression. Int Wound J 2023;20:131-9. DOI: https://doi.org/10.1111/iwj.13847
6. Huang C, Wu Z, Du Y, Ogawa R. The Epidemiology of Keloids. In: Téot L, Mustoe TA, Middelkoop E, Gauglitz GG, eds. Textbook on Scar Management: State of the Art Management and Emerging Technologies. Springer International Publishing; 2020:29-35. DOI: https://doi.org/10.1007/978-3-030-44766-3_4
7. Isamah CP, Akpomiemie MO, Otene CI. Epidemiology and Pattern of Presentation of Keloids at a Tertiary Hospital in Southern Nigeria. Niger Health J 2024;24:1535-42.
8. Kassi K, Kouame K, Kouassi A, et al. Quality of life in black African patients with keloid scars. Dermatol Reports 2020;12:8312. DOI: https://doi.org/10.4081/dr.2020.8312
9. Kiprono SK, Chaula BM, Masenga JE, et al. Epidemiology of keloids in normally pigmented Africans and African people with albinism: population‐based cross‐sectional survey. Br J Dermatol 2015;173:852-4. DOI: https://doi.org/10.1111/bjd.13826
10. Kouotou EA, Nansseu JR, Omona Guissana E, et al. Epidemiology and clinical features of keloids in Black Africans: a nested case-control study from Yaoundé, Cameroon. Int J Dermatol 2019;58:1135-40. DOI: https://doi.org/10.1111/ijd.14610
11. Chike-Obi CJ, Cole PD, Brissett AE. Keloids: pathogenesis, clinical features, and management. Semin Plast Surg 2009;23:178-84. DOI: https://doi.org/10.1055/s-0029-1224797
12. Kelly AP. Keloids. Dermatol Clin 1988;6:413-24. DOI: https://doi.org/10.1016/S0733-8635(18)30653-3
13. McGinty S, SW. Keloid. In: StatPearls [Internet]. StatPearls Publishing; 2020.
14. Liu A-H, Sun X-L, Liu D-Z, et al. Epidemiological and clinical features of hypertrophic scar and keloid in Chinese college students: A university-based cross-sectional survey. Heliyon 2023;9:e15345. DOI: https://doi.org/10.1016/j.heliyon.2023.e15345
15. Okoh PD, Amachree EWA, Paul JN. Prevalence of Keloid among Female Students with Multiple Ears Piercing in the University of Port Harcourt, Nigeria. Scholars Academic Journal of Biosciences 2020;8:88-91. DOI: https://doi.org/10.36347/sajb.2020.v08i04.003
16. Stanley GHM, Pitt ER, Lim D, et al. Prevalence, exposure and the public knowledge of keloids on four continents. J Plast Reconstr Aesthet Surg 2023;77:359-70. DOI: https://doi.org/10.1016/j.bjps.2022.11.017
17. Ung CY, Warwick A, Onoufriadis A, et al. Comorbidities of Keloid and Hypertrophic Scars Among Participants in UK Biobank. JAMA Dermatology 2023;159:172-81. DOI: https://doi.org/10.1001/jamadermatol.2022.5607
18. Swenson A, Paulus JK, Jung Y, et al. Natural History of Keloids: A Sociodemographic Analysis Using Structured and Unstructured Data. Dermatol Ther (Heidelb) 2024;14:131-49. DOI: https://doi.org/10.1007/s13555-023-01070-3
19. Wanjala NF, Joseph G, Anthony M, et al. Keloids: Does patients’ sex influence the presentation and recurrence post-excision? J Plast Reconstr Aesthet Surg 2022;75:366-8. DOI: https://doi.org/10.1016/j.bjps.2021.08.030
20. Kyeyune EATM. Ethnicity and nationalism in Uganda. Nordiska Afrikainstitutet; 2002.
21. Uganda Bureau of Statistics. National Population and Housing Census 2014 – Main Report. Kampala (Uganda): Uganda Bureau of Statistics; 2016.
22. Glass DA 2nd. Current Understanding of the Genetic Causes of Keloid Formation. J Investig Dermatol Symp Proc 2017;18:S50-3. DOI: https://doi.org/10.1016/j.jisp.2016.10.024
23. Clark JA, Turner ML, Howard L, et al. Description of familial keloids in five pedigrees: evidence for autosomal dominant inheritance and phenotypic heterogeneity. BMC Dermatol 2009;9:8. DOI: https://doi.org/10.1186/1471-5945-9-8
24. Garve R, Garve M, Türp JC, et al. Scarification in sub-Saharan Africa: social skin, remedy and medical import. Trop Med Int Health 2017;22:708-15. DOI: https://doi.org/10.1111/tmi.12878
25. Oluwasanmi JO. Keloids in the African. Clin Plast Surg 1974;1:179-95. DOI: https://doi.org/10.1016/S0094-1298(20)32271-9
26. Shaheen A, Khaddam J, Kesh F. Risk factors of keloids in Syrians. BMC Dermatol 2016;16:13. DOI: https://doi.org/10.1186/s12895-016-0050-5
27. Nangole FW, Ogeng’o J, Agak G, et al. Blood group and Human Leucocyte Antigen sub-type as determinants to keloid formation and recurrence in keloid patients. Pan-African J Plast Reconstruct Aesthet Surg. 2024;1.
28. Padmalakshmi BM, Ravi KC, Chirra LR, et al. Association between blood group and hypertrophic scar. J Plast Surg Transplant 2020;1:45-7.
29. Mouhari-Toure A, Saka B, Kombaté K, et al. Is There an Association between Keloids and Blood Groups? ISRN Dermatol 2012;2012:750908. DOI: https://doi.org/10.5402/2012/750908
30. Perdanakusuma KDPD. The relationship between blood type and the formation of keloid post wound. Jurnal Rekonstruksi & Estetik 2012;1.

Supporting Agencies

This work was funded by the Government of Uganda through the Makerere University Research and Innovations Fund (MakRIF) under the funding for PhD research grants, for the fiscal year 2022/2023.

How to Cite



1.
Mbiine R, Wayengera M, Kiwanuka N, Munabi I, Muwonge H, Nakanwagi C, et al. Epidemiology of keloids among university students in Uganda. Dermatol Reports [Internet]. 2025 Nov. 26 [cited 2026 Apr. 18];. Available from: https://journals.pagepress.net/dr/article/view/10396
Copyright (c) 2025 the Author(s) Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.