Keloid Scars
What is a keloid?
Formation of scar tissue is a normal part of healing, but some individuals are prone to develop keloid scars and hypertrophic scars.
Keloids are scars that grow over time and extend beyond the initial site of injury due to impaired wound healing. Keloids can develop anywhere the skin is injured but are most common on the earlobes, cheeks, chest, shoulders and upper back. They frequently recur and rarely regress.
Keloids are not harmful but they can be aesthetically displeasing, cause itching, discomfort and psychological stress.
What is the difference between a keloid scar and a hypertrophic scar?
Hypertrophic scars are also the result of abnormal wound healing. Keloid formation is an abnormal form of wound healing that results in excessive production of collagen. Keloids spread beyond the site of the initial skin injury while hypertrophic scars stay within the original wound borders.
What are the symptoms of a keloid scar?
A keloid is a raised, thick, firm, rubbery scar. They may not form immediately but may develop months after the injury. In a younger person, a keloid can enlarge as the person grows.
What causes a keloid?
The exact cause is unknown but is believed to be an inherited abnormal response to tissue injury, linked to inflammation. When the skin is injured, the body deposits collagen to fill in and heal the wound. A keloid scar occurs when there is an overproduction of collagen.
A keloid can develop from an insect bite, a pimple, a burn, an injection or surgery in genetically susceptible individuals. If you have known risk factors or have had keloids in the past it is wise to avoid tattoos, piercings and unnecessary surgeries.
What are the risk factors for developing a keloid scar?
- possessing an inherited abnormal response to tissue injury
- having a darker skin tone
- being younger than age 30
- having blood type A
How is a keloid diagnosed?
Generally keloids are diagnosed by their clinical appearance. However, if needed a small biopsy will be taken to confirm the diagnosis.
What are the treatments for a keloid scar?
Keloids and hypertrophic scars are characterized by continuous local inflammation and excessive collagen deposits. Thus, treatment is often targeted to reduce inflammation and suppress scar formation. Treating keloids can be complicated and difficult and may require a combination of treatments to achieve the best results.
Examples of treatment options:
- Steroids are well known for their anti-inflammatory effect and can effectively treat keloids and hypertrophic scars.
- Local steroid injections can help reduce their size and appearance.
- Silicone gel dressings are used to reduce inflammation and can help to prevent scar and keloid formation.
- Chemotherapy drugs can be used for more difficult to treat lesions.
- Laser therapy can improve the texture and appearance of the scar.
- Surgical excision is not recommended unless combined with other forms of therapy
If you are genetically predisposed to developing keloids, it is important to get early treatment for conditions that lead to scarring such as acne.
Please contact our office for a consultation to discuss the treatment options for keloids and scarring.
