Notably, keloids, an example of abnormal wound healing, are far more common in individuals with skin of color, including African American, Latinx, and Asian adolescents, reflecting both genetic susceptibility (e.g., transforming growth factor beta (TGF-β) pathway polymorphisms) and environmental triggers such as acne, piercings, or injury [9]. This evidence concerns the gene TGFB1 and keloid.