Keloids are thick scar tissues which are often unsightly and are more of a cosmetic concern rather than pathological.
Scar formation and Keloids
As everyone is aware of,scar is the reponse of the body to any wounds or irritation and is a normal response towards healing.Often these scars are limited to the wound and generally fade away with time.However,in some people,this scar tissue can overgrow the original wound aggressively resulting in Keloids.So in effect,the healing process creates more insult to the skin than the wound itself.
Where are Keloids usually seen?
Keloids can occur anywhere in the body but ceratin sites are prone for their development.These are:
Earlobes
Chest
Shoulder
Cheek
Neck
Back
Why does a Keloid form in the first place?
Though we are still in dark regarding the exact cause of keloid formation,the underlying factor is undoubtedly a dysfunction in the normal wound healing process. Genetic factors and race constitute two important independent risk factors.African and Asian population especially with strong history of keloids are mostly vulnerable.
What type of injury can lead to keloids?
Any type of skin injury can evolve into a keloid if one is prone.Some of the commonly encountered causes are:
Surgical cuts
Insect bites
Acne
Rashes
Body piercings
Tattooes
Burns
Vaccination pricks.
What are the symptoms of keloids?
A keloid can form over time irrespective of the point of injury.
Pay special attention in the presence of following symptoms and signs:
Thick irregular scarring
Reddish brown or black discolouration which varies as per skin colour but invariably keeps darkening than the surrounding skin
Itchy or painful scar
Typical sites as mentioned above.
How long does my keloid last?
Keloids can continue to grow but usually stops after a period of time.However they do not resolve spontaneously unless specific treatment is taken.
Treatment
Treatment is warranted not because of the health hazzards-which are practically nil-but because of the psychological trauma it can have on the patient,particularly if it is on the face or visible areas.
Surgical excision is the treatment of choice.However,enumerated below are the various management options:
Compression therapy: Here,compression dressings are applied over the wound as it heals to put pressure on and thereby to inhibit the scar growth.These devices can be uncomfortable, as people need to wear them for 6 to 12 months.
Cryotherapy: Cryotherapy with liquid nitrogen is aimed at freezing the keloid but can have side effects like loss of colouration of skin,rashes etc.
Laser therapy
Radiation Therapy
Silicon gels and patches to flatten the keloids.
Steroid injection: Multiple sessions of injection of steroids into the keloids have been successful in reducing inflammation and thereby decreasing the size of the keloids and the annoying symptoms.It is commonly performed as an outpatient procedure in hospitals.
Surgical treatment: Often done in conjunction with other therapies,this involves the surgical removal of keloids but with a high risk of recurrence.
Stem cell therapy is being studied for potential use in keloids.
Mutiple products are available in the market these days claiming to be beneficial for keloid but most of them have no scientific basis and are not at all recommended. There have been claims that the plant Centella asiatica is effective for treatment of scarring but evidences are inconclusive.
Can I prevent Keloid formation if I’m at risk of developing one?
Treat any apparently minor injury with care as anything can progress onto keloid if you are prone.
Protect from re-injury as friction can be triggering.
Always consult your doctor if you find yourself in a likely situation.
Whom should I consult for Keloid treatment?
A plastic surgeon or a dermatologist is the ideal choice.
Remember keloids can mimic many alternate dermatological conditions such as ‘Hypertrophic scar’ or ‘Nodular scleroderma’.Better consult your doctor straightaway for accurate diagnosis and management.
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