Another tick bite question

[va medic]

This is a new one on me!  A friend of mine has an old tick bite site on her back that is raised (about 1-2 mm above skin level), non-pigmented, and has hardening of the skin tissue.  It is not a perfect circle, but rather an irregular spot about 2 inches wide by about an inch or so high.  She tells me that the site gets slightly larger every year.  Seems to be no pain or itching at the site.  The doctors she has shown it to (not specialists) seem to have no idea what it could be, how to stop it from spreading, or what she could do to soften up the skin.  Any ideas what this might be and if anything can be done?

Thanks!

[Alan Rockoff, MD]

The back commonly gets keloids (thickened scars.)  These can follow surgery, minor trauma, or nothing at all.  Your friend may recall a spocific tick bite, or may just be assuming that's what did it.  In any case, the persistence is what you'd expect from a keloid, and sometimes they do spread over time.  Injections of cortisone can flatten them, but surgery only makes the scar worse.  Unless it's bothersome, perhaps it's best to leave it alone.

Best.

Dr. Rockoff