Unwieldy wounds Healing from wounds has three main phases. The first is an inflammatory phase that prevents or limits further damage. There’s a proliferative phase during which new tissue is formed. Among the many things that occur in this phase, specialized cells called fibroblasts produce collagen that helps create structural suppors for new tissue. This proliferative phase isn’t discreet; it can go on in the background throughout the healing process. Last, there’s a maturation phase when the new tissue settles into its final form and gains maximum strength. When keloids form , it means something went wrong in the proliferative phase of healing. Specifically, the fibroblasts of keloids are thought to be more active, survive longer, and produce more collagen and more signaling molecules that promote growth. Collagen production in keloids can be 20 times larger than in typical skin. It’s unclear what triggers this uncontrolled tissue growth, but genetics and environmental factors are thought to play a role.…